Introduction: We aimed to characterize features that can accurately identify preterm infants at risk of delay in oral feeding attainment. Methods: A prospective observational study of infants born between 250/7 and 326/7 weeks’ gestation. Early independent oral feed attainment (EPO) was defined as independent oral feeding within 35 days of initiation and late attainment (LPO) defined at or after 35 days following initiation. Candidate characteristics of comparison included feeding interventions and reasons for feeding discontinuation. Results: Of the 257 infants included, 162 infants achieved EPO. Over the first week of oral feeding, LPO infants received fewer feeding interventions (e.g., side lying position, pacing, and re-alertment) and were fed less frequently (2 vs. 3 times per day; p < 0.001). Conclusions: Compared to infants with EPO, infants with LPO differ in employed feeding strategies. These findings could guide resource allocation and facilitate the provision of individualized care.

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