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Area of Science:

  • Neonatal Care
  • Pediatric Nutrition
  • Evidence-Based Practice

Background:

  • Independent oral feeding is crucial for NICU discharge and impacts length of stay.
  • Significant variation exists in oral feeding protocols within and between NICUs.
  • The Infant-Driven Feeding (IDF) method uses behavioral assessments (readiness, quality, caregiver support) for communication.

Purpose of the Study:

  • To review evidence on the Infant-Driven Feeding (IDF) method's impact on oral feeding initiation and achievement.
  • To assess the IDF method's effect on time to independent oral feedings.
  • To evaluate the IDF method's influence on length of stay in NICU/level II nurseries for preterm infants.

Main Methods:

  • Searched four databases (CINAHL, Medline/PubMed, Ovid Nursing, Embase) for relevant feeding methodologies.
  • Used keywords: "infant guided feedings," "infant driven feeding," "cue-based feeding," "co regulated feeding."
  • Reviewed 32 full-text articles for experimental, quasiexperimental, or retrospective study designs.

Main Results:

  • No experimental, quasiexperimental, or retrospective studies specifically using the IDF method were identified.
  • Three quality improvement projects utilized the IDF method with conflicting findings.
  • One project showed IDF improved achievement of oral feedings; two showed reduced length of stay; one found no significant differences.

Conclusions:

  • Current evidence supporting the Infant-Driven Feeding (IDF) method is limited to quality improvement projects.
  • Empirical validation of the IDF method is necessary.
  • Further research is required to guide practices for initiating and advancing oral feeding in preterm infants.