A cross-sectional analysis of infant-driven and traditional feeding outcomes for neonatal intensive care unit infants
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Audrey Lane1, Jonathan Pacella2, James R Beal3
1University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA.
Insights
Infant-driven feeding (IDF) initiated oral feeding earlier in NICU infants. However, IDF did not significantly improve other key outcomes like feeding tube removal, length of stay, or breastfeeding rates.
Area of Science:
- Neonatal care
- Pediatric nutrition
- Clinical outcomes research
Background:
- Traditional feeding protocols in Neonatal Intensive Care Units (NICUs) are standard practice.
- Infant-driven feeding (IDF) is an alternative approach focusing on infant cues for feeding initiation.
- Assessing the comparative effectiveness of IDF is crucial for optimizing neonatal care.
Purpose of the Study:
- To evaluate the impact of infant-driven feeding (IDF) versus traditional feeding protocols on achieving successful feeding outcomes in neonates.
- To determine if IDF promotes earlier oral feeding and other key clinical milestones.
Main Methods:
- A cross-sectional analysis was conducted on infants in a level three NICU over a two-year period.
- Infants were categorized into two groups: those managed under a traditional feeding protocol and those under an IDF protocol.
- Outcomes including age at first feed, nasogastric (NG) tube removal, discharge, length of stay, and breastfeeding rates were compared.
Main Results:
- Infants in the IDF group demonstrated significantly earlier initiation of oral feeding compared to the traditional group (p < 0.001).
- No statistically significant differences were observed between the groups regarding age at NG tube removal, age at discharge, length of hospital stay, or the percentage of infants breastfeeding at discharge.
- These findings held true for subgroups of infants born prematurely at <35 and <32 weeks gestation.
Conclusions:
- The infant-driven feeding (IDF) protocol successfully facilitates earlier initiation of oral feeding in the NICU setting.
- Despite earlier oral feeding, IDF did not translate into significant improvements in other critical outcomes such as earlier NG tube removal, reduced length of stay, or increased breastfeeding rates at discharge.
- Further research may be needed to explore modifications or complementary strategies to enhance the overall benefits of IDF in neonatal care.
Objective:
The goal of this study was to assess the impact of infant-driven feeding (IDF) compared to traditional feeding protocols in promoting earlier successful feeding outcomes.
Study Design:
We performed a cross-sectional analysis of infants admitted to a level three neonatal intensive care unit (NICU) over a 2-year period. We compared infants fed with the traditional protocol to those under the IDF protocol.
Results:
Infants in the IDF group were younger at first feed (p < 0.001). There was no difference in age at nasogastric (NG) tube removal or at discharge, length of stay, or percentage breastfeeding at discharge. There were no differences in outcomes within two subgroups born at <35 and <32 weeks gestation, respectively.
Conclusion:
The IDF program led to earlier initiation of oral feeding. However, this did not lead to earlier NG tube removal or discharge, a shorter length of stay, or increase in the rates of breastfeeding.
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