The Importance Of Feeding Performance In Premature Infants

There are more than 70% of premature babies that are born between 34 and 36 weeks gestation a year. When a baby is born early, or born with birth defects, the Neonatal Intensive Care unit is its first home. The nurse’s in the NICU have the difficult job of preparing baby’s and parents for a health life together. A baby who has been put into the NICU will stay there until it is healthy enough to go home.

Healthy term infants are able to dictate their frequency of feeding and the amount of milk intake. This is primarily dictated by the infant's appetite. Preterm infants, on the other hand, may not typically be able to dictate the frequency and amount of milk intake. In most instances, preterm infants are fed at scheduled intervals and making use of prescribed milk volumes. The main reason behind scheduled feeding, without regard for the child's sleep or hunger status, is the concern about the infant's metabolic, neurodevelopmental, as well as gastrointestinal, maturity. However, it is evident that preterm infants are also capable of self-regulating their milk intake. While hunger cues may be difficult to detect in preterm infants, there is sufficient evident for mothers and caregivers to identify and respond to such cues. This paper will examine and analyze the experience of policy development on cue-based feeding in preterm infants. Cue-based feeding is a formidable feeding strategy in preterm infants (Chang & Chen, 2004).

According to the World Health Organisation [WHO] (2014) pre-term babies are at increased risk of illness, disability and death. It also states that globally 15 million babies are born pre-term and the figures are rising. In England and Wales during 2012 7.3% of live births were pre-term under 37 weeks nearly 85% of all babies born prematurely will have a very low birth weight (Office for National Statistics, 2012). Pre-term birth is associated with respiratory complications and lung disease, long-tern neurological damage and problems with bowel function (Henderson & Macdonald, 2011). Neonatal services provide care to babies who are born prematurely or are ill and require specialist care. It is seen that sixty per cent of infant deaths occur in the neonatal period (DH,

Neonatal Nurse Practitioners (NNP) refers to and cares for newborns in their first 28 days of life. Neonatal nurse practitioners practice advanced skills in order to provide care for healthy newborns, as well as newborns who need individualized attention. These nurses care for premature and sick newborns in many different settings: neonatal intensive care units (NICU), emergency rooms, delivery rooms, or specialty clinics(Nurse). NNP’s level of care enables them to preform multiple duties consisting of: monitoring specialized equipment, providing education to the families of the sick newborns, administering medications, preforming diagnostic tests and other procedures in order to establish a treatment plan for the newborns,

The method used was double blind randomized control study, the neonates were placed into either the experimental or control group by computer. The study was conducted by registered nurses who all had at least two years of experience in the NICU as a staff nurse. The nurse obtaining the study data remained blind to whether the patient received the intervention of sucrose or not, by stepping out of the room while the patients primary nurse opened up an envelope containing information if the patient was to receive 0.5mL of sucrose or not. The primary nurse would then administer the sucrose if indicated prior to the nurse collecting data for the study would return. The sucrose was administered between one and three minutes prior to the arterial puncture procedure. Every neonate was swaddled for the procedure and a pacifier was held in place lightly while the arterial puncture was performed. The nurse investigator would obtain the NIPS score, heart rate, and oxygen saturation, after the needle was inserted and then one minute after completion of the procedure. Milazzo, et al. (2011), found that the average gestation of the neonate in this study was 33.8 weeks and there was no difference in age of gestation for the experimental or control groups. The NIPS score was found to be between zero and three

Less than 30 years ago the survival rate of premature babies was 25%, now that number has risen to a survival rate of 90%(Dutton, Judy). The increase in this number is most likely due to the advanced medicine and technology and the help of neonatal nurses. By having an advancement in technology and medicine gives us a wider range to work with to help these premature babies survive. Neonatal nurses are there to help contribute to the health of these babies so they can grow strong and healthy. Within nursing, especially neonatal nursing, that has been around since early 1900s have helped save and nurture our babies of the future.

A baby's stomach cannot hold an increased amount of food, so formulas and breast-milk must have high caloric content in order to satisfy their nutritional needs. Supplements are also necessary and greatly assist babies that experience difficulty in extracting all of the required nutrients during their regular feedings. A baby may also simply tire out during its feedings due to its stressed heart and lungs, and will not eat its fill. In these situations, a nasogastric tube can be utilized to lessen the work

Premature birth occurs in 11.7% of pregnancies in the United States. With the introduction of new technology in the neonatal intensive care unit (NICU), premature infants are now kept alive at lower birth weights, with more severe diagnoses, and a greater likelihood of surviving to discharge to be cared for by parents.( Brady E. Hamilton; Joyce A. Marti; Stephanie J. Ventura 2012 p.305) An important role to neonatal nursing includes consultation, research, and education of families and staff.

During pregnancy, mothers are often faced with the personal decision of whether they should breastfeed or formula-feed their newborn. This paper discusses the advantages and disadvantages of each feeding method. The purpose of this paper is not to shame a mother for the feeding method she chooses, but instead to provide understanding into the reasons why a mother may choose breastfeeding over formula-feeding. A commonly asked question is: “Is breast really best?” There is no right or wrong choice, just the best choice for mom and baby.

In this article, DiBlasi argues that the conventional method used to provide ventilatory support to preterm neonates with respiratory distress syndrome; nasal continuous positive airway pressure (CPAP) is ineffective. The author bases the claim on the fact that almost half of the infants supported by this technique often develop respiratory failure that warrants invasive ventilatory support and endotracheal intubation that is injurious in nature. According to the author, invasive ventilatory procedures should be avoided to minimize the excessive complications that are usually associated with them.

An essential component of nutritive feeding is the suck, swallow, breathe coordination. When this coordination is compromised, an infant may not receive appropriate nutrition and therefore, will not have optimal growth. There are three different categories of the nutritive suck, which are referred to as immature, transitional, and mature. When an infant demonstrates 3-5 sucks per burst, their sucking pattern is considered immature. If an infant demonstrates 6-10 sucks per burst, they are considered to have a transitional

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

The rate of exclusive breast-feeding at OHSU before they implemented the new pacifier policy was 80%, however researchers were hoping to increase this percentage. By implementing this new policy the hospital was moving towards becoming a “Baby-Friendly” hospital. This term is only applicable to 10% of hospitals in the United States and not giving pacifiers to breast-fed babies is one of the ten steps required for this coveted certification. Researchers at OHSU were shocked to find that when they limited infant pacifier use exclusive breast-feeding rates decreased. Researchers discovered “after tracking 2,249 babies born between June 2010 and August 2011 [WANT TO DELETE they noted] that exclusive breast-feeding rates dropped from 79% of infants between July and November 2010 to 68% between January and August 2011” (Rochman, 2012 p. 1). The percentage of babies that only received formula remained consistent, while infants that required supplemental formula increased from 18% to 28%. Dr. Carrie Phillipi a Co-author of the study and associate professor of pediatrics at OHSU was really surprised at the effects of limiting pacifier use, she thought “limiting pacifier use would improve breast-feeding rates” (Rochman, 2012 p. 1). Dr. Phillipi presented at the annual meeting of the Pediatric

A premature baby may have a small, soft feeding tube placed through the nose of mouth into the stomach. If the infant is having breathing problems, a tube may be placed into the trachea in order to have a ventilator help the baby breathe. Depending on the baby’s progress, they may need a less severe treatment such as continuous positive airway pressure (CPAP) with small tubes in the nose instead of the windpipe or they may only need extra oxygen. Preterm infants need to stay in the NICU until they are able to breath without extra support, eat by mouth, and maintain body temperature and body weight.

Proven as the ideal method for feeding babies, nationwide 76% of new moms choose to breastfeed and forgo formula feeding, but by three months post-partum that percentage has dropped drastically (Centers for Disease Control and Prevention’s (CDC) Division of Nutrition, Physical Activity, and Obesity 4). While breastfeeding is proven to reduce the risk of diarrhea, pneumonia, obesity, type-II diabetes, and improve results on intelligence tests (World Health Organization) many new moms abandon their goals of feeding babies for the recommended 2 years (World Health Organization) because of the discrimination received while nursing in public. Being viewed as a life choice, not a health choice, the general public ostracizes and alienates these women, arguing that modesty is more important than a baby’s right to eat. In 2012, a study performed by Lansinoh Breastfeeding found that while “79% of moms know that breastfeeding is the best choice for a healthy baby” (Lansinoh Laboratories Inc., fig. 1), an unbelievable 40% say their biggest fear pertaining to breastfeeding is nursing in public (Lansinoh Laboratories Inc.). Pleading that nursing a baby is natural, multitudes of comments counter that argument, saying defecation, urination, and even sexual intercourse is natural as well, but they aren’t doing it in public. These types of comments are disadvantageous to breastfeeding success rates and are regulating women to restrooms, changing rooms, hot vehicles, and even homes, in