Last November, NANT members were invited to participate in a survey on oral feeding in their NICU. YOUR insights were enlightening and displayed best efforts on how we can collaborate to model a safer, more effective future for NICU feeding practices.
Now the RESULTS –
Both safety and quality scored an average rating of 3 out of 5, indicating that neonatal therapists collectively rated current feeding practices as unexceptional. Even more concerning, safety—a foundational, non-negotiable aspect of care1—received the same mediocre score. What does this tell us about the gap between our reality and our standards?
NICU infants aren’t always the most refined feeders, and this can lead to issues outside of their control. By ensuring that products and practices are consistent, reliable, and grounded in solid evidence, offering safe feedings is within control. Are parents questioning the safety of the feeding practices for their infant? What explanation do parents receive when the caregiver is unsure? It’s a scenario none of us should ever have to face—yet our own ratings suggest it’s not out of the question.
Over the past two years, various surveys have been presented to therapists, NICU nurses, and multidisciplinary neonatal teams (including providers) across numerous hospitals in several cities and states. Astonishingly, there is a consistent average rating of 3.2
Now the BARRIERS –
Every day, caretakers strive to provide unrivaled care for NICU babies and their families. The ultimate goal is to provide safe feeding experiences with the highest quality of care. What are the barriers that keep a safety and quality rating hovering at “3”—mediocre, average, or moderate quality?
The TOP 5 barriers to safe, high-quality feeding that neonatal therapists chose are listed below.
- Focus on the quantity over the quality of feeding
- Unsupported strategies to “finish” oral feeds
- Unpredictably fast nipple flow rates
- Unreliable/inconsistent nipples (e.g., disposable nipple units)
- The absence of consistent staff education
Now the SOLUTIONS –
The Good News: These Are Solvable Problems.
The good news is that each of these barriers can be resolved by implementing an immediate solution. Evidence-based standards of care and reliable, supportive products are the solutions to these barriers and will elevate the feeding culture in the NICU.
Now the GOALS –
- We focus on the quality of feeding over quantity.
Quality comes first—volume follows.3,4,5,6,7,8,9,10
- We do not use unsupportive strategies to finish feeds.
Infants should never be pushed or manipulated to eat. Unsupportive strategies can create negative feeding experiences, which may even lead to oral aversions.11
- We match nipple flow rates to each infant’s skill.
A safe, supportive flow rate helps infants succeed and go home with confidence.12,13
- We use reliable, consistent bottle systems.
Disposable nipples are highly variable; their safety must be reconsidered.14
Using a vented bottle that prevents pressure buildup and eliminates subatmospheric
pressure may improve feeding performance.15
- We provide evidence-based, consistent education.
Standardization links quality education and training to better outcomes.16
Now the COMMITMENT –
82% of respondents reported “Feeding Practice Education” is their top goal for 2025.
Building a Stronger Feeding Culture—Together.
Culture is shaped by your team’s values, attitudes, skills, and behaviors. A strong team collaborates to plan, reflect, communicate, and manage risks effectively.16
The survey question “What discipline ‘drives the feedings’ on your unit?” revealed that the most common selection was Nurses. Since the goal is to “Build a Stronger Feeding Culture,” the optimal response so that all collaborate, is that feeding decisions should include every team member, including families. Feeding is a team effort.
Thank you to everyone who participated in the survey. Your voice matters. Dr. Brown’s Medical is proud to stand with you in our shared mission of “Feeding Together” to improve outcomes for infants and families.
For more information about products and practices that can enhance feeding outcomes, contact us at medinfo@drbrownsmedical.com.
And don’t miss our next Feeding Together call, where we’ll chat with a neonatal therapist about how her unit transformed its feeding culture. Bring your toughest questions—the experienced therapist and the Dr. Brown’s Medical team are ready to help problem-solve!
Register here: https://us06web.zoom.us/
Click here to view references.
