MAM: Constanze, I’m delighted to have the chance to speak with you about speech therapy support for premature infants.
Constanze Valerie Vetter: Thank you very much for the opportunity to present my work in more detail.
MAM: In your daily work, you support premature babies who struggle with oral development. At what point are you brought in as a speech therapist?
Constanze Valerie Vetter: Many premature babies have difficulties coordinating sucking, swallowing and breathing. This skill typically matures between the 30th and 34th week of pregnancy. If this coordination is not fully developed breathing pauses can occur during feeding. In addition, premature infants are often very sensitive to stimuli in and around the mouth, which can lead to an overreaction
As a speech therapist, I treat newborns with swallowing disorders or feeding difficulties. With premature babies, I usually start therapy when they reach the developmental stage corresponding to around 32 weeks of pregnancy, as oral feeding would be possible at that point.
MAM: How does speech therapy support for premature babies generally work, and what are your main goals?
Constanze Valerie Vetter: Speech therapy aims to help the infants transition from tube feeding to full oral feeding. One of the key goals is learning to coordinate sucking, swallowing and breathing. At first, I test the baby’s oral sensitivity and check the rooting, sucking and swallowing reflexes. The path to the first drinking attempt often takes time and involves several intermediate steps. Gentle massages help stimulate and strengthen the muscles in the mouth and face. Stroking the inside of the mouth can reduce hypersensitivity. It’s important that the babies perceive touch positively, and to involve the parents right from the start.
MAM: Do you use tools such as soothers during therapy with premature infants?
Constanze Valerie Vetter: In the neonatal intensive care unit (NICU), the soother almost has the status of a medication, as non-nutritive sucking (sucking without food intake) has a pain-relieving effect and supports the baby’s self-regulation. In speech therapy, the soother is also used as a therapeutic tool to promote oral sucking, strengthen the muscles in the mouth area and improve sensory regulation. Initially, the baby receives tube feeding while sucking on a soother. The next step involves giving small drops of milk into the baby’s mouth using a syringe with a silicone tip – the so-called finger feeder, while they are sucking on the finger/pacifier to connect sucking and swallowing. During breastfeeding, nipple shields are often used, as the mother’s nipple is still too large for the infant and the baby lacks the strength to latch on it. Sometimes, supplemental nursing systems are used. Bottles are also an option.
MAM: How do you support premature babies and their parents on the way to independent feeding?
Constanze Valerie Vetter: Only when sucking and swallowing work well, the reflexes are intact and the baby can tolerate sensory input, oral feeding can begin. If breastfeeding is the goal, the baby is first put to the breast while still being tube-fed. If the mother wishes, bottle feeding is also possible. I give parents precise instructions: the bottle should be held horizontally to slow the milk flow, and the teat should be well placed in the mouth to trigger the sucking reflex. Later, breast and bottle can be combined within one feeding session.
MAM: You’re familiar with MAM baby bottles, teats and other products from your work. I’m particularly interested in your experience with the MAM preterm soothers (note: MAM Preemie and MAM Comfort).
Constanze Valerie Vetter: I use the MAM Preemie Soother for premature babies very often. In my opinion, it’s the best soother for pre-term infants among all those I’ve tried. It’s small, very soft, and the shield can be flexibly adjusted depending on the placement of the feeding tube or respiratory support. The hole in the shield is also very practical for using a finger feeder. When the babies are more mature (around 34 weeks), th=ey sometimes need stronger oral stimulation – then I switch from the MAM Preemie to the MAM Comfort soother. The choice depends on the individual baby and their level of sensitivity.
MAM: Do you accompany the babies only during their hospital stay, or also after discharge?
Constanze Valerie Vetter: Usually, I accompany premature babies only during their hospital stay. The good news is that almost all of them no longer need special treatment after discharge. If a speech-related issue arises later, for example a shortened tongue tie that wasn’t noticeable before, parents can always contact me and come to the outpatient clinic or practice with their child.
MAM: You also treat full-term babies. Are there any differences compared to preterm infants?
Constanze Valerie Vetter: The therapeutic approach is similar in both groups. However, the causes of feeding difficulties differ - for full-term babies, birth-related factors may play a role. Another difference is that full-term babies are generally less sensitive to stimulation, which simplifies therapy.
MAM: What motivates you in your daily work?
Constanze Valerie Vetter: It’s wonderful to watch premature babies develop. Over time, the parents also become more confident in caring for their child. That’s when all the effort pays off. The most rewarding moment for me is when breastfeeding works properly for the first time. That gives me the energy for my work.
MAM: The 17th of November marks World Prematurity Day. What does this awareness day mean to you?
Constanze Valerie Vetter: I think it’s very important to raise awareness of premature birth and to show that a start in life can look different. The time in hospital with a premature baby is often long and filled with fear and worry. I see World Prematurity Day as a chance to open conversations and bring together people who have shared similar experiences.
MAM: What message would you like to share with parents of premature babies?
Constanze Valerie Vetter: I want to encourage parents to trust their intuition and to take time to recharge. Most importantly: a mother who doesn’t breastfeed is not a bad mother! Breast milk has great value – especially for digestion and the immune system in the first weeks – but later it’s just as important to have time for positive experiences with the baby. Knowing that breastfeeding and expressed milk feeding can be combined is often a great relief for parents.
This interview was created in collaboration with an expert who received compensation from MAM. Published in November 2025.
Recommended reading on the topic of speech therapy support for premature babies:
- Biber, D. (2014). Frühkindliche Dysphagien und Trinkschwächen. Berlin/Heidelberg: Springer.
- Hübl, N., Kaufmann, N., Randweg, S. (2020). Präventive Arbeit auf der neonatologischen Station. Beitrag der Logopädie zur Ernährungsentwicklung von Frühgeborenen und kranken Neugeborenen. Forum Logopädie, 34(6), 30-35.
- Medizinische Universität Wien, Universitätsklinikum Wien (2022). Ratgeber Logopädie. Tipps zur Entwicklung und Förderung der oralen Funktionen. Wien: Wiener Gesundheitsverbund.
