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Clinical Applications of EEG in Infant Feeding Assessment and Prediction of Feeding Outcomes: A Narrative Review
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Clinical Applications of Brain Mappin
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Presenter Author:
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Elmira Shokri
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Author:
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Elmira Shokri - Corresponding - Presenter
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University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran
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Abstract
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Original Research
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introduction :
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Infant feeding is a complex neurodevelopmental process that requires coordinated central nervous system, sensorimotor, cardiorespiratory, and gastrointestinal functions. Prematurity and neonatal neurological conditions, particularly hypoxic-ischemic encephalopathy (HIE), may disrupt this coordination and delay the transition to full oral feeding. Electroencephalography (EEG) provides a non-invasive measure of cerebral electrical activity and may offer early neurophysiological biomarkers associated with feeding progression. This narrative review examined the current evidence for clinical applications of EEG in the assessment and prediction of infant feeding outcomes.
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Methods:
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A narrative review was conducted for original human studies published from January 2020 to August 2026. PubMed/MEDLINE was used as the primary biomedical database, supplemented by targeted searches of scholarly indexing and publisher platforms. Search concepts combined infant/neonate populations, EEG-based measures—including conventional EEG, quantitative EEG (qEEG), and amplitude-integrated EEG (aEEG)—and feeding-related outcomes. Studies were included when they investigated EEG measures in neonates or infants and reported clinically relevant feeding outcomes. Findings were synthesized narratively because of substantial heterogeneity in populations, EEG methodologies, and outcome measures.
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Results:
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Six studies directly examined associations between EEG-based measures and feeding-related outcomes. Across studies of perinatal asphyxia and HIE, greater abnormalities in early EEG background or quantitative cortical activity were generally associated with longer time to full oral feeding or nasogastric tube (NGT) weaning. Quantitative EEG features recorded during the first 24 hours after perinatal asphyxia showed associations with time to NGT discontinuation. In late-preterm infants, a pilot model combining aEEG and heart-rate variability explained 53% of the variance in time to full oral feeding. However, evidence was not uniform: early aEEG in extremely preterm infants was associated with later neurodevelopmental measures but not with standardized feeding outcomes.
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Conclusion:
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Current evidence suggests that early EEG-based measures may have prognostic value for feeding progression, particularly in infants with perinatal asphyxia or HIE. However, evidence supporting EEG as a direct diagnostic tool for sucking, swallowing, or oropharyngeal dysphagia remains limited. EEG should therefore be considered a complementary neurophysiological measure within multidisciplinary assessment rather than a replacement for standardized clinical feeding and swallowing evaluation. Larger prospective studies using standardized EEG and feeding outcomes are needed to establish its clinical utility.
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| Attachment:
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| Keywords:
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electroencephalography; infant feeding; neonatal feeding; quantitative EEG; amplitude-integrated EEG; oral feeding; feeding outcome
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| Key message:
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