Evaluation of Cue-Based Oral Feeding Protocols for the Preterm Infants in the Neonatal Intensive Care Unit (NICU)
Abstract
ABSTRACT
PURPOSE: The purpose of this study was to evaluate the use of two feeding protocols. Both feeding protocols included the implementation of oral stimulation, the use of feeding readiness cues, and a quality of nippling scale. Infants were evaluated prior to and after implementation of the oral stimulation program and the feeding protocols. SUBJECTS: A convenience sample of 1155 preterm infants less than 37 weeks gestation were included in the study. DESIGN: Quasi-experimental, retrospective, quantitative. METHODS: Data were collected from chart reviews of infants from a pre-intervention group that did not receive the feeding protocol and a post-intervention group that received oral stimulation and a cue-based feeding protocol. MAIN OUTCOME MEASURES: Gestational age at first nipple feed, gestational age at full nipple feedings, and gestational age at discharge. PRINCIPLE RESULTS: T-tests were performed on the entire group of preterm infants comparing the pre-intervention group with the post-intervention group. T-tests were also performed on groups of preterm infants of varying gestational ages. As a total group of preterm infants there were no statistically significant differences in the outcome measures. In the post-intervention group of infants under 26 weeks gestation, the first oral feeding occurred seven days earlier than in the pre-intervention group, resulting in a statistically significant finding (p=0.05). In this same group, there were clinically significant results. Infants achieved full oral feedings nine days earlier, and they were discharged eight days earlier than infants who did not receive oral stimulation or the feeding protocols. Only infants under 26 weeks gestation who received oral stimulation achieved full feeds and was discharged earlier than infants who did not receive oral stimulation. CONCLUSION: Our cue-based feeding protocol and oral stimulation program improved the time it takes for extremely preterm infants to reach full feedings which can impact their readiness for discharge. Being discharged earlier will decrease the cost of care in the NICU. Feeding readiness protocols also provide guidance in assessing preterm infants.
PURPOSE: The purpose of this study was to evaluate the use of two feeding protocols. Both feeding protocols included the implementation of oral stimulation, the use of feeding readiness cues, and a quality of nippling scale. Infants were evaluated prior to and after implementation of the oral stimulation program and the feeding protocols. SUBJECTS: A convenience sample of 1155 preterm infants less than 37 weeks gestation were included in the study. DESIGN: Quasi-experimental, retrospective, quantitative. METHODS: Data were collected from chart reviews of infants from a pre-intervention group that did not receive the feeding protocol and a post-intervention group that received oral stimulation and a cue-based feeding protocol. MAIN OUTCOME MEASURES: Gestational age at first nipple feed, gestational age at full nipple feedings, and gestational age at discharge. PRINCIPLE RESULTS: T-tests were performed on the entire group of preterm infants comparing the pre-intervention group with the post-intervention group. T-tests were also performed on groups of preterm infants of varying gestational ages. As a total group of preterm infants there were no statistically significant differences in the outcome measures. In the post-intervention group of infants under 26 weeks gestation, the first oral feeding occurred seven days earlier than in the pre-intervention group, resulting in a statistically significant finding (p=0.05). In this same group, there were clinically significant results. Infants achieved full oral feedings nine days earlier, and they were discharged eight days earlier than infants who did not receive oral stimulation or the feeding protocols. Only infants under 26 weeks gestation who received oral stimulation achieved full feeds and was discharged earlier than infants who did not receive oral stimulation. CONCLUSION: Our cue-based feeding protocol and oral stimulation program improved the time it takes for extremely preterm infants to reach full feedings which can impact their readiness for discharge. Being discharged earlier will decrease the cost of care in the NICU. Feeding readiness protocols also provide guidance in assessing preterm infants.