1.       · Drowsy, alert, or fussy before cares

            · Rooting and/or bringing hands to mouth/taking pacifier

           · Good tone (presupposes autonomic stability)

2.      · Drowsy or alert once handled

         · Some rooting or taking of pacifier

          · Adequate tone

3,      · Briefly alert with cares

          · No hunger behaviors

          · No change in tone

4.     · Sleeps throughout cares

        · No hunger cues

        · No change in tone

5.    · Needs increased oxygen with cares

        · Apnea and/or bradycardia with cares

        · Tachypnea greater than baseline with cares

‘QUALITY OF NIPPLING’ SCALE

1.    · Nipples with a strong coordinated suck throughout feed

2.   · Nipples with a strong coordinated suck initially but fatigues with progression

3.  · Nipples with consistent suck, but has difficulty coordinating swallow. 

       Some loss of liquid or difficulty in pacing.

4.  · Nipples with a weak/inconsistent suck.  Little to no rhythm. 

        May require some rest breaks. 

5.  · Unable to coordinate suck-swallow-breathe pattern despite pacing. 

        May result in frequent or significant A/Bs or large amounts of liquids loss

        and/or tachypnea significantly greater than baseline with feeding..

‘CAREGIVER TECHNIQUE’ SCALE

· External pacing

· Modified sidelying

· Chin support

· Cheek support

· Oxygen modification