Changes in Oral Feeding in Preterm Infants 2 Weeks After Hospital Discharge☆,☆☆
Section snippets
Methods
Data for the analysis were collected in two studies of preterm infant feeding. The first was a non-experimental study of feeding readiness in 95 preterm infants that included 22 infants who were included in a 2-week post-discharge follow-up study.17 The second was an experimental study of four feeding approaches to the transition from gavage to oral feeding in 109 preterm infants that included 63 infants who were retained for the 2-week post-discharge follow-up of feeding skill. Both studies
Results
There were 12 female and 10 male infants in the sample from the first study; 59% were Black/African American. The mean birth weight of these 12 infants was 1322 grams (SD, 457) and their mean PMA at birth was 29.6 weeks (SD, 1.9 weeks). The mean weight of the infants at the pre-discharge measurement was 2149 g (SD, 305) and the mean PMA at discharge was 35.3 weeks (SD, 1.2 weeks). At the post-discharge observation, the mean weight of the infants was 2834 g (SD, 436.11) and the mean PMA was 38
Discussion
The EFSA demonstrated good reliability in all five domains in both samples, supporting its potential usefulness for both research and clinical practice. Various domains on the EFSA in both samples were found to be significantly different from discharge to 2 weeks post-discharge, supporting that infants’ feeding skills continue to change and mature after discharge. In particular, the domains that demonstrated significant changes over time were associated with the infants’ abilities to remain
Conclusion
This analysis has demonstrated that the EFSA has adequate internal consistency and moderate predictability of post-discharge outcomes. The tool, while somewhat lengthy, is not difficult to use or score. Moreover, there are opportunities to learn how to use the tool at various short-course training sessions offered by the tool's authors.
The use of reliable measures of feeding skill, such as the EFSA, may provide needed data to determine when an infant's feeding skills are competent enough to
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Cited by (12)
Clinical Validation of the Preterm Oral Feeding Readiness Assessment Scale in Taiwan
2021, Journal of Pediatric NursingCitation Excerpt :This volume-driven approach may achieve short-term success but can cause long-term problems after NICU discharge (Cerro et al., 2002; Hawdon et al., 2000; Mathisen et al., 2000). According to relevant research, almost 15% of preterm NICU infants are rehospitalized after discharge and experience feeding tribulation in the first 2 weeks (Pickler et al., 2012), and 20%–80% of these infants encounter feeding problems during infancy (Field et al., 2003; Rommel et al., 2003). Infants' integrated neurodevelopmental maturity, behavioral cues, and environmental interactions are known factors that promote stable feeding, oral feeding readiness and behavioral development (Kish, 2013; Lubbe, 2018; Ludwig & Waitzman, 2007).
Dietary transition difficulties in preterm infants: Critical literature review
2016, Jornal de PediatriaCitation Excerpt :Prematurity is considered a risk factor, because the infant's anatomical and physiological immaturity predisposes to a number of adaptation and evolution difficulties in post-natal life.1
Preterm infants' orally directed behaviors and behavioral state responses to the integrated H-HOPE intervention
2014, Infant Behavior and DevelopmentCitation Excerpt :Future research is critical to identify interventions that improve oral feeding skills, especially for more fragile preterm and full-term infants who are at greater risk for organizing their behaviors prior to feeding or who have difficulty with oral feeding progression. Intervention that builds the preterm infant's capacity for successful oral feeding is critically needed (Lau & Smith, 2012; Pickler et al., 2010; Pickler, Reyna, Griffin, Lewis, & Thompson, 2012; Thoyre et al., 2012). The data reported in the current study are suggestive that offering a pre-feeding intervention may enhance the infant's preparation for oral feeding by increasing the frequency of orally directed behaviors and proportion of time spent in an alert behavioral state.
Evaluating sucking maturation using two pressure thresholds
2013, Early Human DevelopmentCitation Excerpt :Pickler and colleagues used the EFS Assessment to measure the feeding skills of 85 preterm infants pre-discharge and at two weeks post-discharge [19]. The authors found the pre-discharge feeding scores as determined by the EFS Assessment to be predictive of post-discharge feeding scores, demonstrating the usefulness of the EFS Assessment for researchers and caregivers [19]. Objective measures of sucking parameters are also used to quantify maturation of sucking over time.
Feeding after discharge
2022, World Review of Nutrition and Dietetics
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Supported by R01 NR005182, R. Pickler, PI, from the National Institute of Nursing Research, National Institutes of Health.
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Work Completed at Virginia Commonwealth University and the Cincinnati Children's Hospital Medical Center.