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Outcomes From an Oral Feeding Protocol Implemented in the NICU

Neonatal Intensive Care Unit Children's Hospital of Illinois at OSF Saint Francis Medical Center, Peoria, Illinois, douglas.c.drenckpohl{at}osfhealthcare.org

Rebecca Dudas, RNC

Neonatal Intensive Care Unit Children's Hospital of Illinois at OSF Saint Francis Medical Center, Peoria, Illinois

Suzanne Justice, MA, SLP-CCC

Pediatric Rehabilitation Department Children's Hospital of Illinois at OSF Saint Francis Medical Center, Peoria, Illinois

Connie McConnell, RN

Neonatal Intensive Care Unit Children's Hospital of Illinois at OSF Saint Francis Medical Center, Peoria, Illinois

Kamlesh S. Macwan, MD

Department of Pediatrics, Division of Neonatalogy, University of Illinois College of Medicine at Peoria, Peoria, Illinois

The purpose of this study was to compare the clinical outcomes of 2 different oral feeding protocols. The old protocol advanced oral feedings based on established feeding times, whereas the new evidenced-based protocol advanced oral feedings using infant cues. This retrospective study, conducted by reviewing the charts of premature infants born less than or at 34 weeks' gestation, documented the differences between the 2 oral feeding protocols. The medical records were reviewed for 200 premature infants admitted to the neonatal intensive care unit at Children's Hospital of Illinois, Peoria, Illinois. The main outcome variables this study compared were when infants started oral feedings, time to achieve 50% and 100% feedings orally, weight at time of oral feeding, day of life, and postmenstrual age. The percentage of feedings when oral stimulation was ordered, frequency of feeding therapy consultations, length of stay, weight at the time of discharge, and postmenstrual age at the time of discharge were also compared. Infants participating in the new feeding protocol began oral feedings at an earlier postmenstrual age as compared to infants using the old feeding protocol. Participants enrolled in this new protocol did not experience adverse events. They were also able to progress to full oral feedings while maintaining adequate weight, had less need for feeding therapy consultations, and length of stay was not prolonged.

Key Words: prematurity • early life span nutrition • transitional nutrition care • growth and development • feeding and swallowing problems

ICAN: Infant, Child, & Adolescent Nutrition, Vol. 1, No. 1, 6-10 (2009)
DOI: 10.1177/1941406408328535


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