About PRIME

The framework began where most feeding assessments stop.

After years of clinical practice at the National Tongue Tie Centre — seeing more than a thousand infants annually — Dr Justin Roche and Kate Roche identified a consistent pattern: families were being seen by multiple clinicians without receiving a unified answer. Feeding was being assessed in fragments. The pieces rarely came together into a clear clinical picture.

PRIME was built to close that gap. It is a five-element clinical framework that integrates the full picture of infant and paediatric feeding — from the parent-infant relationship and physiological readiness, to biomechanical alignment, motor patterning, and the embodiment of feeding as a natural default.

It works for families navigating feeding difficulties without clear answers. And it works for clinicians who want a structured, cross-disciplinary framework they can teach and apply consistently.

Kate Roche’s clinical foundation in infant feeding dates from 1998, when she worked as the Regional Neonatal Physiotherapist for Southampton and the wider Hampshire area, providing specialist physiotherapy input across neonatal services in the region. During this period she completed training with Joan Lacey, the Australian neonatal physiotherapist and developer of the Lacey Assessment of Preterm Infants, and was trained in the Brazelton Neonatal Behavioral Assessment Scale. This early clinical work included teaching specialist handling and positioning of babies to the neonatal team, to support physiological stability and regulation, with outcomes monitored through baseline physiological markers. That foundation, combined with her subsequent specialist training as an IBCLC and Paediatric Feeding Therapist, underpins the therapeutic framework of PRIME.