Discrepancy between defining and intervening with premature feeding and swallowing in the NICU: a survey

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University of Alabama Libraries

Feeding during infancy is a complex, multidimensional task that involves dynamic coordination between sucking, swallowing, and breathing (Wolf & Glass, 1992). Infants born prematurely, however, often display delayed swallow and/or immature/uncoordinated suck, swallow and respiration (Amaizu et. al, 2008). Neonatal Intensive Care Unit (NICU) guidelines for discharge typically include the following four physiological competencies: thermoregulation, control of breathing, respiratory stability, feeding skills and weight gain (Jefferies, A.L, 2003). A recent evidenced based systematic review that investigated the variables used to define successful feeding in the literature showed significant variability in the outcome measures used by medical and allied health professionals. This project sought to document the variables used by practicing speech language pathologists and nurses that care for premature infants in the NICU setting to define “successful feeding”, the potential influencers of those definitions, and to determine if a quantifiable difference exists in the variables used to label feeding as successful or unsuccessful between the two disciplines. The results showed that the variability documented in the literature, for identifying successful feeding, is also seen in current clinical practice. Further research to develop a standardized clinical guideline and to determine the efficacy of feeding/swallow interventions is warranted to guide clinicians through this intricate process of decision-making.

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Speech therapy