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Oral feeding practices in medically complex infants receiving prolonged high-flow nasal cannula support: A

Emily Cox1, Jasneek Chawla2,3, Madison Moore4

  • 1School of Clinical Medicine, The University of Queensland, Brisbane, Queensland, Australia.

Journal of Paediatrics and Child Health
|September 30, 2024
PubMed

Insights

High-flow nasal cannula (HFNC) support for infants with chronic conditions can hinder oral feeding progression. Further research is needed to optimize feeding outcomes for these vulnerable infants.

Area of Science:

  • Neonatology
  • Pediatric Respiratory Care
  • Speech-Language Pathology

Background:

  • Infants with chronic conditions often require prolonged respiratory support.
  • High-flow nasal cannula (HFNC) is a common respiratory support method.
  • Feeding difficulties are prevalent in infants requiring extended medical interventions.

Purpose of the Study:

  • To characterize the feeding profile of infants receiving prolonged HFNC.
  • To examine the care pathway for these infants, including speech pathology input.
  • To identify barriers to oral feeding in infants dependent on HFNC.

Main Methods:

  • Retrospective review of electronic records for HFNC-dependent infants (≥2-3 L/kg for ≥5 days).
  • Data collected included medical history, HFNC details, feeding outcomes, and speech pathology (SLP) care.
  • Infants with acute respiratory conditions were excluded.

Main Results:

  • 24 infants with complex chronic conditions were included; median HFNC use was 37.5 days.
  • 83.3% received SLP input, but HFNC requirements were a common barrier (45%).
  • Only 9.1% were discharged on full oral feeds, despite some improvement in feeding methods.

Conclusions:

  • Prolonged HFNC support in infants with chronic conditions shows variability in oral feeding management.
  • HFNC itself acts as a barrier to advancing oral feeding.
  • Further research is crucial to ensure safe and effective oral feeding strategies for this cohort.
Abstract

Keywords:
deglutition disorderhigh‐flow nasal cannulainfantoral feedingrespiratory therapy

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