Improving Feeding Outcomes Of An Infant Driven Feeding Pathway

1478 Words Aug 26th, 2015 6 Pages
Improving Feeding Outcomes in the NICU:
Establishing an Infant-Driven Feeding Pathway
Laura Pabich BSN, RN
The University of Iowa College of Nursing Improving Feeding Outcomes in the NICU:
Establishing an Infant-Driven Feeding Pathway
The most common reason preterm infants face prolonged hospitalization in a Neonatal Intensive Care Unit (NICU) is a delay in acquiring full oral feedings (Shaker, 2013). The purpose of this project is to improve feeding outcomes for preterm infants at Blank Children’s Hospital’s (BCH) NICU in Des Moines, Iowa. Traditionally, feeding practices in the NICU have followed a physician-led, volume-driven model based on an infant’s weight and gestational age. This model defines a preterm infant’s
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Feeding difficulties often persist past NICU discharge with an incidence ranging from 19 to 80 percent (Shaker, 2013; Sundseth, 2013). The average daily cost for NICU care often exceeds $3,500 per infant and a delay in establishing full oral feedings further increases the cost of care (Murakas, 2008). Delayed discharge also places infants at risk for hospital related morbidity, leads to prolonged maternal child separation and increases parental stress (Gennattasio, Perri, Baranek, & Rohan, 2015).
Preterm infants face a number of challenges in attaining full oral feedings including physiologic instability, neurologic immaturity and behavioral state disorganization (Gennattasio, Perri, Baranek, & Rohan, 2015). The time in which preterm infants are learning to feed is characterized by rapid motor and neurodevelopment in which every feeding experience plays a role (Shaker, 2013). Physiologic stress during feeding may encourage sensory-motor pathways in the brain, leading to maladaptive feeding behaviors, learned feeding refusals and long-term feeding aversions (Shaker, 2013). Traditional, volume-driven feeding practices fail to account for an infant’s hunger cues, the physiologic stress caused by the challenge of oral feeding and the quality of an individual feeding (Newland, Weems L’Huillier, & Petrey, 2013). According to Sundseth Ross and Browne (2013), feeding practices must move from
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