Determining oral feeding readiness in preterm infants is difficult and involves many aspects, including observations of behavioural state, physiological responses to the environment, oral skills and motor skills. Premature infants are challenged when developing the skills needed for effective oral feeding due to an immature neurological system, underdeveloped motor skills and poor autonomic regulation. Because of an infant’s complex needs and immature development, recognizing oral readiness signs alongside other important indicators when planning the introduction of oral feeding can be hard to gauge accurately. This article focuses on nurse practitioner understanding of oral readiness during an informal study completed in an inner city level 1 neonatal unit