Olivia’s mom walks nervously into the NICU. Although Olivia has been stable and growing well for the past several weeks, and was even transitioned recently to nasal cannula, her mom still has occasional waves of anxiety when she comes to visit. However this week has also been filled with feelings of excitement because Olivia is starting to eat by mouth! Mom arrives around her scheduled feeding time. She changes Olivia’s diaper and carefully swaddles her with the new blanket she brought from home. Olivia remains awake and is mouthing her fingers. Staff hands mom the bottle. Olivia begins feeding but after a couple of minutes stops sucking and falls asleep.
“I think she’s done, she doesn’t want any more.”
“Here, give her to me, I’ll get her to take it.”
Most of us have probably observed this scenario before. Well-intentioned caregivers want to do everything possible to help a baby succeed with feeding. In the family-centered model of care, the family would presumably be key players in facilitating the transition to full oral feeding. However, we are sometimes asked “this baby is just starting to feed and this mom has never fed a preemie before, shouldn’t we do the feeding? “
Researchers from University of Milan sought to determine the effects of parental involvement in feeding on the timing of achievement of full oral feeds in preterm infants. This prospective observational study enrolled 81 infants born <32 weeks and recorded several medical variables along with the day of life in which kangaroo care was initiated, oral feeding was initiated, and parents began to feed the baby. Length of time to full oral feeding was also calculated, and the number of times that parents fed their infants was tracked. The study results demonstrated that the earlier that kangaroo care was initiated and the earlier parents fed their babies, the lower the post-menstrual age at time of full oral feedings. Additionally, low birth weight, BPD, and the need for gastrointestinal surgery were associated with higher post-menstrual age at time of full oral feedings.(1)
This study illustrates the importance of early parent involvement in the feeding process, and the authors highlight that feeding is a complex task developmentally and behaviorally and requires active engagement from the infant and the family.
Based on the results of this study, neonatal therapists can:
– Educate parents on the benefits of kangaroo care, as well as the logistics and transfer methods for kangaroo care. Kangaroo early and often!
– Assist parents in understanding their infant’s behavioral cues.
– Support parents in feeding their infants, even in the early stages of the process. Depending on the skill level of the baby, this may involve more or less support from the therapist, but parent involvement in feeding is crucial.
(1) Gianni, M., Sannino, P., Bezze, E., Comito, C., Plevani, L., Roggero, P., et al. (2016). Does parental involvement affect the development of feeding skills in preterm infants? A prospective study. Early Human Development, 103, 123-128.