Abstract The purpose of this study was (a) to investigate the validity of the revised Neonatal Oral Motor Assessment Scale (NOMAS) in discriminating between efficient and inefficient feeders in a sample of high-risk premature neonates and (b) to identify significantly different oral motor behaviors in the two groups. The revised NOMAS rates normal and abnormal characteristics of nutritive and nonnutritive sucking. The 26 subjects were classified by the amount of liquid they consumed during the first 5 min of feeding. The findings demonstrated that both nutritive and nonnutritive sucking scores were higher in the efficient feeders than in the inefficient feeders and that the revised NOMAS scores accurately classified the two groups. Characteristics that were significantly associated with inefficient feeding were lack of rhythm, disorganization in jaw and tongue movements, and pauses of more than 6 sec. Often, these responses appeared to be related to respiratory patterns.