As a company that frequently interacts with neonatal therapists, we often hear the question, “How do we get our Providers to value the developmental aspect of feeding?”
While Providers focus on supporting positive outcomes for the infants in their care, they typically depend on the staff to ensure the infant is successfully feeding upon discharge.
Recent practices surrounding neurodevelopment have prompted neonatal Providers to align with neuroprotective supportive feeding practices. In fact, in a recent discussion at a neonatology conference, a Provider shared, “Feeding is my jam!” How enlightening to neonatal therapists for a Provider to be excited about feeding. The foot is in the door, so how do we open it wide?
Speak Their Language.
“Show them the research”
Are your unit’s feeding practices supported in the literature? The literature supports cue-based feeding,1,2,3 even more specifically, Infant-Driven Feeding®.** In addition, the works of Britt Pados and Katlyn McGrattan have shed light on the importance of consistency of feeding tools and the science behind bottle feeding.4,5,6,7
Refer to VON Principles
The Vermont Oxford Network (VON) is a nonprofit collaboration of healthcare professionals worldwide working to change the landscape of neonatal care. Their mission is “to improve the quality, safety, and value of care for newborn infants and their families through a coordinated program of data-driven quality improvement, education, and research.”8
From 2023 to 2026, a focus of VON is All Care is Brain Care. Neuroprotection is no longer only a neonatal therapist’s responsibility but is now the responsibility of all. VON states “Every interaction with an infant and their family in the neonatal intensive care setting is an opportunity to be brain-focused and have a direct impact on the developing brain.” As we know, this includes feeding. The VON standards now include oral feeding-related items in their practice gap assessments such as:
-Promote positive olfactory and gustatory experiences
-Infant-driven/cue-based feeding protocol
-Ongoing skin-to-skin
If your hospital is a member of the VON network, speak with your VON representative. Even if your hospital is not a member, there are free resources/videos to learn more about All Care is Brain Care at https://public.vtoxford.org/
Apply Standards of Neonatal Practice
Infant Family-Centered Developmental Care (IFCDC) – In 2020, the Consensus Committee on Recommended Standards, Competencies, and Best Practices for Infant and Family-Centered Developmental Care in the Intensive Care Unit provided guidelines for NICU Developmental Care.9 This committee was comprised of a variety of NICU disciplines, including MDs. The guidelines include a section on the management of feeding, eating, and nutrition delivery. Recommendations for best practices in this section include competencies such as 1) Consistency of feeding practices among staff who feed an infant shall be promoted, monitored, and verified; and 2) All oral experiences should be based upon the baby’s behaviors and focused on enjoyable non-stressful interactions. Find out more about these guidelines at: https://nicudesign.nd.edu/
AAP Standards for Levels of Neonatal Care II, II, and IV – These standards, published in 2023 by the American Academy of Pediatrics, affirm the need for a nationally consistent standard of care to improve neonatal outcomes. Information includes identification of resources that are to be provided, including therapy, and a description of the Neonatal Patient Safety and Quality Improvement Program. This program assists units with selecting quality measures and reviews of guidelines and policies. Practically, this guideline can be used to demonstrate the need for measuring changes a unit makes related to feeding practices in their units, or to help a therapy team provide a case for adequate coverage in the NICU.10
Now that the door is open, “Speak Their Language.” Communicate in ways that matter or are familiar to them. Facilitate positive, neuroprotective feeding experiences to last a lifetime.
To view references, click here.
**For a full reference list to support Infant-Driven Feeding®, please reach out to Dr. Brown’s Medical at idfinfo@drbrownsmedical.com
