Abstract
Background: Volume based feedings continue to be utilized in NICUs despite their association with increased length of stay, feeding aversion, and physiologic instability during feedings. Cue-based feeding has been shown to support neurodevelopment and organized feeding behaviors in the premature population, resulting in improved physiologic stability during feedings, decreased time to full oral feedings, and shorter hospital stays.|Problem: Volume driven feeding practices can have a negative impact on premature infant’s neurodevelopment and continue to be utilized in NICUs.|Purpose: The purpose of this project was to implement a standardized cue-based feeding protocol for premature infants in the NICU.|Participants & Setting: Participants were premature infants born between 23 0/7 and 34 6/7 weeks gestation and admitted to the 44 bed level III NICU at Cape Fear Valley Medical Center.|Methods: Key stakeholders in the NICU collaborated over several months to develop a cue-based feeding protocol. The protocol described which infants would qualify and included the recommended progression of feedings. A pre and post-implementation chart review was completed, on 44 participants, by comparing the average time to achieve full oral feedings, average number of cardiorespiratory events that occur during feedings, length of stay, weight gain velocity, and rates of breastfeeding.|Results: There was a decrease in the mean number of days to full oral feedings, length of stay, and the number of cardiorespiratory events with feedings. Breast feeding rates and weight gain velocity were decreased post-implementation.|Conclusion: A standardized cue-based feeding protocol had a positive impact on the premature infant population at this community hospital. Continued utilization of the protocol may result in positive feeding experiences, decreased length of stay, and hospital costs.