Early discharge of premature infants < 37 weeks gestational age with nasogastric tube feeding: the new standard of care?

Abstract

Most premature infants are hospitalised until they no longer need monitoring of vital parameters and are independent of nasogastric tube feeding (NTF). Hospital admission time easily reaches a length of multiple months in extremely preterm infants, but also in late preterms, in whom drinking may be the only problem, hospital admission time can reach weeks. This is a very stressful time for both parents and child. Parents in the Albert Schweitzer Hospital (ASH) are taught to give their child NTF. When monitoring is no longer necessary, the child can be discharged with NTF, with home care by paediatric nurses. In this study duration of NTF at home, safety of the procedure and parental satisfaction with NTF at home were evaluated. Duration of NTF at home was compared to admission time from cessation of monitoring till discharge independent of NTF in infants born in two comparable hospitals where discharge with NTF is not standard care. Median duration of NTF at home in the ASH infants was 9 days. In the control group, median admission time after cessation of monitoring was 9 days. No complications related to NTF at home were noted. Ninety-six percent of parents regarded NTF at home as safe and would repeat it in the future.Conclusion: NTF at home in premature infants shortens hospital admission time, is safe and results in high parental satisfaction rates. What is Known: • Premature infants are most often hospitalised until they are no longer dependent on NTF. Hospital admission time therefore easily reaches a length of multiple months for the extremely preterm infant. This can be a very stressful time for both parents and child. What is New • Making discharge with NTF in otherwise stable premature infants possible, by teaching parents the procedure and by providing home care by paediatric nurses. • NTF at home in premature infants is safe, limits hospital admission time and has high parental satisfaction rates.

Keywords: Hospital admission time; Nasogastric tube feeding (NTF) at home; Premature infants.