TABLE 2.

Examples of EFS Items within Each Section

Oral Feeding Readiness
Able to hold body in a flexed position with arms/hands toward midline			Yes	No
Demonstrates energy for feeding—maintains muscle tone and body flexion through assessment period			Yes	No
Oral Feeding Skill
Ability to Remain Engaged in Feeding
Predominant muscle tone (energy infant demonstrates for feeding)	Maintains flexed body position with arms toward midline	Inconsistent tone, variable muscle tone	Some tone consistently felt, but somewhat hypotonic	Little or no tone felt; flaccid, limp most of the time
Ability to Organize Oral-Motor Functioning
Opens mouth promptly when lips are stroked at feeding onsets	All	Most	Some	None
Once feeding is under way, maintains a smooth, rhythmic pattern of sucking
Ability to Coordinate Swallowing and Breathing
Able to engage in long sucking bursts (7–10 sucks) without behavioral stress signs or an adverse or negative cardiorespiratory response
Ability to Maintain Physiologic Stability
In the first 30 seconds after each feeding onset, oxygen saturation is stable, and behavioral stress cues absent
Stops to breathe before behavioral stress cues appear
Clear breath sounds—no grunting breath sounds (prolonging the exhale, partially closing glottis on exhale)
Oral Feeding Recovery (During the First Five Minutes Postfeeding)
Predominant state	Quiet Alert	Drowsy	Sleep	Fuss/Cry
Range of oxygen saturation (%):