European Journal of Pediatrics

, Volume 177, Issue 5, pp 665–673 | Cite as

Predictors and outcomes of the Neonatal Oral Motor Assessment Scale (NOMAS) performance: a systematic review

  • Laura Longoni
  • Livio Provenzi
  • Anna Cavallini
  • Daniela Sacchi
  • Giunia Scotto di Minico
  • Renato BorgattiEmail author


The NOMAS is by far the most used tool to screen early oral-motor skills in newborns. Here we provide an updated review of scientific literature on the use of the Neonatal Oral Motor Assessment Scale (NOMAS) to screen early oral-motor skills in newborns. An integrative review has been carried out consistent with PRISMA guidelines and standardized qualitative appraisal. Data abstracting and synthesis were executed by two independent co-authors who solved disagreement in conference. Twenty records have been included and reviewed. The efficacy of the NOMAS in screening and identifying precocious oral-motor skills received inconsistent support. Moderate validity and low reliability emerged. Moreover, despite the NOMAS’ adequately screen efficient and inefficient feeders, limited evidence emerged for predictive value of NOMAS score on feeding and psychomotor developmental trajectories during the first 2 years of age.

Conclusion: The present review highlights benefits and limitations of the NOMAS. Future research is needed to develop observational and clinically-relevant tools to better identify newborns which are at lower- and higher-risk of developing less-than-optimal feeding behaviors and to guide with greater precision the diagnostic and therapeutic journey of these newborns.

What is Known:

The assessment of oral-motor skills in newborns and infants is critical for early intervention

• The NOMAS is the most adopted tool to assess oral-motor skills in newborns and infants

What is New:

The ability of the NOMAS to target newborn at risk for feeding disorders is confirmed

• Nonetheless, the capacity to predict long-term developmental outcomes is limited


NOMAS Oral-motor skills Preterm infants PRISMA Review 



Bronchopulmonary dysplasia


Neonatal Oral Motor Assessment Scale


Preferred Reporting Items for Systematic Reviews and Meta-Analyses


small for gestational age



We are grateful to the colleagues of the Neuropsychiatry and Neuro-rehabilitation Unit and of the 0-3 Center for the at-Risk Infant for their daily support in clinical and research activities.

Authors’ contributions

Author LL performed literature search, Author AC and author DS provided clinical supervision, LP wrote the first manuscript draft, GSDM provided thorough revision of the final draft, and RB conceived the study. All authors approved the final manuscript for submission.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Informed consent

Not applicable.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Neuropsychiatry and Neurorehabilitation UnitScientific Institute IRCCS Eugenio MedeaBosisio Parini, (LC)Italy
  2. 2.0-3 Center for the at-Risk InfantScientific Institute IRCCS Eugenio MedeaBosisio Parini, (LC)Italy

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