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To Individualize the Management Care of High-Risk Infants With Oral Feeding Challenges: What Do We Know? What Can We
1Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States.
Insights
Preterm infants often struggle with safe oral feeding due to immature physiological functions, leading to prolonged NICU stays. This review highlights evidence-based tools and tailored strategies to improve feeding outcomes for these vulnerable infants.
Area of Science:
- Neonatology
- Developmental Pediatrics
- Clinical Nutrition
Background:
- Increased survival rates in preterm infants over 30 years highlight challenges with safe and efficient oral feeding.
- Difficulties in oral feeding lead to adverse events like oxygen desaturation, bradycardia, and aspiration, prolonging neonatal intensive care unit (NICU) hospitalization.
- Prolonged NICU stays result in delayed mother-infant bonding, increased maternal stress, breastfeeding difficulties, and higher healthcare costs.
Purpose of the Study:
- To review the physiological underpinnings of oral feeding difficulties in preterm infants.
- To examine current clinical practices for managing these feeding challenges.
- To present evidence-based tools and interventions for improving oral feeding in preterm infants.
Main Methods:
- Literature review focusing on physiological immaturity, current feeding practices, and emerging evidence-based interventions.
- Analysis of research on tools and strategies for neonatal oral feeding.
- Synthesis of information to propose a renewed perspective on tailored management.
Main Results:
- Preterm infants exhibit immature physiological functions impacting oral feeding safety and efficiency.
- Current management practices lack validated guidelines, leading to inconsistent care.
- Evidence-based tools and interventions are increasingly available to support preterm infant feeding.
Conclusions:
- Addressing the physiological basis of feeding difficulties is crucial for preterm infants.
- There is a need for validated guidelines and protocols to standardize care.
- Tailoring management strategies using evidence-based tools can optimize oral feeding outcomes and improve infant and family well-being.
Abstract:
The increase in preterm infants' survival over the last 30 years has shed light over their inability to feed by mouth safely and efficiently. With adverse events such as increased risks for oxygen desaturation, bradycardia, penetration/aspiration, infants' hospitalization in neonatal intensive care units (NICUs) are understandably prolonged. Unfortunately, this leads to delayed mother-infant reunion, maternal stress, breastfeeding obstacles, and increased medical costs. Such impediments have stimulated clinicians and researchers to better understand the underlying causes and develop evidence-based solutions to assist these infants. However, it is notable that the research-to-practice translation of this knowledge has been limited as there are still no validated guidelines or protocols as how to best diagnose and care for these infants. This report revisits the immature physiologic functions at the root of these infants' oral feeding difficulties, the current practices, and the recent availability of evidence-based efficacious tools and interventions. Taking advantage of the latter, it presents a renewed perspective of how management strategies can be tailored to the specific needs of individual patients.
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