1 What is the POFRAS Scale?
POFRAS -- the Preterm Oral Feeding Readiness Assessment Scale -- is implemented in PediAid based on Fujinaga et al. (2013), scoring 18 items across 5 domains, each rated 0 to 2, for a maximum of 36 points. The app displays the result as one of three bands: under 28 is 'Not Ready for Oral Feeding,' 28-29 is 'Borderline Readiness,' and 30 or above is 'Ready for Oral Feeding,' each paired with a specific recommended next step and re-assessment interval.
3 Formula & method
The scale covers 18 items across 5 domains, exactly as structured in the app: Domain 1, Corrected Gestational Age (1 item: <=32 weeks scores 0, 33-34 weeks scores 1, >=35 weeks scores 2); Domain 2, Behavioral Organization (3 items: State of Alertness, Postural Tone, Tolerance to Stimulation); Domain 3, Oral Posture (2 items: Lip Posture, Tongue Posture); Domain 4, Oral Reflexes (4 items: Gag Reflex, Bite Reflex, Rooting Reflex, Sucking Reflex); and Domain 5, Non-Nutritive Sucking (8 items: Ability to Latch, Lip Seal During Sucking, Sucking Bursts, Sucking Rhythm, Tongue Tip Elevation, Jaw Excursion, Suction Generation, Endurance). Each item scores 0 (absent/poor), 1 (partial/inconsistent), or 2 (present/good), summing to a maximum of 36. The app's result bands and guidance: under 28 -- 'Not Ready for Oral Feeding,' continue non-nutritive sucking practice and oral stimulation, re-assess in 48-72 hours; 28-29 -- 'Borderline Readiness,' consider a short oral feeding trial (1-2 sucks) under close supervision, re-assess after 24-48 hours; 30 or above -- 'Ready for Oral Feeding,' may be trialled on oral feeds with continuous monitoring of physiological stability, sucking efficiency, and tolerance.
4 Frequently asked questions
What does a POFRAS score below 28 mean?
Per the app, it's classified 'Not Ready for Oral Feeding': continue non-nutritive sucking practice and oral stimulation, and re-assess in 48-72 hours.
What are the 5 domains scored in POFRAS?
Corrected Gestational Age, Behavioral Organization, Oral Posture, Oral Reflexes, and Non-Nutritive Sucking, totaling 18 items.
What's the maximum possible POFRAS score?
36 points -- 18 items, each scored 0 to 2.
What should happen with a borderline score of 28-29?
The app recommends considering a short oral feeding trial (1-2 sucks) under close supervision, and re-assessing after 24-48 hours.
Does a high POFRAS score alone determine feeding decisions?
No -- the app's own clinical note states POFRAS is a validated tool to support decision-making, and that clinical judgement, parental input, and interdisciplinary team assessment should always guide final feeding decisions.