2018 Research Forum

Infant Driven Feeding in the Neonatal Intensive Care Unit Investigator/Presenter Team: Maria Cabrera RN, Kristi Bean RN, Renae Chapa RN, Ashely Reyes RN Departmental Sponsor: Pamela Gavin RN BSN; NRP Coordinator Maria Cabrera RN 1 , Kristi Bean RN 1 , Renae Chapa RN 1 , Ashely Reyes RN 1 1 Cohort 2, Nurse Resident Program INTRODUCTION Research shows that cue based feeding is beneficial in a variety of ways for the infant. In the search for evidence based nursing practice, team members observed that many NICU infants (<37 weeks of gestation) are volume fed. Volume based feeding has been shown to feed past the infant’s interest and capability, producing stress cues such as coughing, pulling away, head turning, arching back, grimacing, drooling, tongue thrusting and O2 desaturation. PURPOSE Our study seeks to assess current feeding practice accurately; longer term goals include improved feeding outcomes potentially resulting in fewer infants who manifesting feeding stress cues and improved weight gain. The long term goal is weight gain linked to decreased NICU length of stay. METHOD The project is based on a unit survey, research and evidence –based practice opinion. Research was based on hospital policies, online publication and printed journal articles; all publications were current within the past 5 years. RESULTS Survey questions 6 and 7 provided findings: Question 7 indicated 20% of babies were fed according to infant hunger cues. Question 6 indicated that in volume fed infants, 24 showed the least desired stress response, O2 desaturation. DISCUSSION This project is the start of implementation of an infant-drive feeding program in NICU. Monitoring is ongoing to track growth/development and determination of readiness to feed. The constellation of infant stress cues shown in volume-fed NICU infants indicate that improved, evidence-based feeding practices can benefit infants and staff. CONCLUSIONS Implementation of evidence based practice for NICH infant feedings can be accomplished through education and ongoing outcome monitoring to track infant growth, development with determination of readiness to feed and related weight monitoring included.

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