Which clinical sign is indicative of feeding difficulties in neonates?

Oxygen desaturation is an important clinical sign that can indicate feeding difficulties in neonates. When a neonate struggles with feeding, it can lead to inadequate intake of nutrients and oxygen, resulting in episodes of hypoxia or oxygen desaturation. This occurs because feeding requires coordination between sucking, swallowing, and breathing. If a neonate is unable to coordinate these actions effectively due to various issues—such as neurological conditions, prematurity, or oral-motor difficulties—they may experience breathing irregularities that manifest as oxygen desaturation during or after feeding.

In contrast, the other options do not typically correlate directly with feeding difficulties. Increased weight gain would generally suggest successful feeding and adequate nutrition. Improved muscle tone might indicate a healthy neurological status, which is usually associated with better feeding capabilities. Normal skin color is an indicator of general well-being and typically reflects good oxygenation and adequate nutrition, not feeding difficulties. Thus, oxygen desaturation stands out as a direct clinical sign of potential challenges a neonate may encounter during feeding.