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Improving preterm infant outcomes: implementing an evidence-based oral feeding advancement protocol in the neonatal

Mary Z Kish1

  • 1DNP Program, Chatham University (2010-2012) and Magee Womens Hospital of the University of Pittsburgh Medical Center, Pennsylvania.

Advances in Neonatal Care : Official Journal of the National Association of Neonatal Nurses
|July 1, 2014
PubMed

Insights

Implementing a standardized oral feeding advancement protocol, including nonnutritive sucking (NNS), in preterm infants reduced time to exclusive oral feedings and length of stay (LOS) in the neonatal intensive care unit (NICU).

Area of Science:

  • Neonatal care
  • Pediatric nutrition
  • Clinical practice protocols

Background:

  • Exclusive oral feeding is crucial for preterm infant discharge readiness from the neonatal intensive care unit (NICU).
  • Current oral feeding advancement interventions often rely on individual nursing judgment.
  • Standardized feeding protocols can decrease variability, shorten gavage-to-oral transition, improve performance, and reduce length of stay (LOS).

Purpose of the Study:

  • To evaluate the implementation of an oral feeding advancement protocol.
  • To standardize oral feeding advancement for medically stable preterm infants in a level III NICU.
  • To assess the impact of a standardized protocol on feeding outcomes.

Main Methods:

  • Literature review to identify key features for successful infant oral feeding.
  • Implementation of a pilot practice change involving a feeding advancement protocol.
  • Inclusion of nonnutritive sucking (NNS) and standardized oral feeding advancement opportunities.
  • Comparison of time to exclusive oral feedings and LOS pre- and post-protocol.

Main Results:

  • Evidence supports nonnutritive sucking (NNS) and standardized protocols for successful preterm infant oral feeding.
  • Pilot implementation included NNS and standardized feeding advancement.
  • Observed reduction in time to exclusive oral feedings and LOS post-protocol implementation.

Conclusions:

  • Preterm infants receiving NNS and following the standardized oral feeding advancement protocol showed reduced time to exclusive oral feedings.
  • A reduction in length of stay (LOS) was observed in infants utilizing the protocol.
  • Statistical significance was not achieved for the observed reductions.
Abstract

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