A national survey of neonatal intensive-care units: criteria used to determine readiness for oral feedings

Abstract

Objective: To describe criteria used to determine readiness for oral feedings in stable, preterm infants.

Design: A 25-item survey questionnaire was mailed to hospitals having level II or level III NICUs.

Setting: Nurseries identified in the 1987 National Perinatal Directory (576 in all) as level II or level III NICUs.

Participants: Head nurses (HN) and staff nurses (SN) at 420 hospitals comprised 73% of the sample surveyed.

Procedures: Survey items were predominantly multiple choice and included an "other" option to encourage comments.

Main outcome measures: Respondents described clinical practice in their nurseries relative to feeding policies, use of traditional decision criteria, or behavioral cues and related interventions.

Results/conclusions: Fewer than 50% of nurseries identified a specific feeding policy for the initiation of oral feedings. Seventy-five percent used either gestational age or weight criteria in deciding when to start oral feedings. Eighty-six percent considered infant behavior as well when determining feeding readiness. Findings suggest an emerging emphasis on infant behavioral cues in addition to gestational age and weight criteria when making feeding decisions.