Did you know:
Prolonged NG tube feedings (>30 days) has been identified as the most prevalent risk factor for later feeding issues
Craniosacaral therapy can be a manual therapy intervention to improve neonatal feeding outcomes
Providing a completely human milk based diet has been associated with reduced incidence of NEC, mortality, late-onset sepsis, ROP, and BDP
As neonatal caregivers we understand that Optimizing Nutrition means more than simply meeting a caloric or volume intake goal. Instead it involves all aspects of oral feeding in the NICU, such as feeding function and quality, safety, and the specific diet requirements. Below you will find a few recent articles to share with your colleagues to assure that your unit is doing everything it can to Optimize Nutrition of the babies you care for.
The Prevalence of Feeding Problems in Children Formerly Treated in a Neonatal Intensive Care Unit
In a study published this year, prevalence of feeding outcomes were tracked for 378 children who were in the NICU for more than 4 days. Follow up assessments were completed 1-2 years after their NICU discharge. The gestational age categories for analysis included <28 weeks, 28-31 weeks, 32-36 weeks and term. Researchers determined the prevalence of feeding problems was 5.4% higher in the NICU group (20.4%) compared to reference population (15%), but similar for all gestational age groups. The most prevalent risk factors for feeding issues were prolonged tube feeding (>30 days) and SGA for those infants born less than or equal to 32 weeks.
Hoogewerf, M., Ter Horst, H., Groen, H., Nieuwenhuis, T., Bos, A., van Dijk, M. (2017). The prevalence of feeding problems in children formerly treated in a neonatal intensive care unit. Journal of Perinatology, 37 (5), 578-584.
Feeding in the NICU: A perspective from a craniosacral therapist
In this recent article, author Karyn Quraishy, discusses the interaction between the nerves and the muscles of the jaw, tongue, and the soft palate and its direct impact on functional sucking and swallowing. Additionally, she reviews how jaw misalignment, compressed nerves, and misshapen heads can interfere with these interactions which can result with feeding difficulties. Quraishly discusses how craniosacaral therapy (CST) can be a perfect treatment approach for the NICU population, as it is a non-invasive manual therapy technique that can release the fascial restrictions affecting the structures involved in feeding. By utilizing this treatment approach feeding outcomes can be improved.
Quraishy, K. (2016). Feeding in the NICU: A perspective from a craniosacral therapist. Neonatal Network, 35(2), 105-107.
Beyond Necrotizing Enterocolitis Prevention: Improving Outcomes With an Exclusive Human-Milk Based Diet.
Researchers in this article compared outcomes of an exclusive human milk-based diet compared to a bovine-based diet, which included mother’s own milk fortified with bovine fortifier and/or preterm formula. Data was collected for 2-3 years prior to and after diets on 1,587 infants whose birth weight was <1,250 grams. Primary outcomes included necrotizing enterocolitis and mortality. Additionally, late-onset sepsis, retinopathy of prematurity and bronchopulmonary dysplasia were secondary outcome measures. This study found the exclusive human milk group had significantly lower incidence of NEC (6.9% compared to 16.7%), mortality (13.6% compared to 17.2%), late-onset sepsis (19% compared to 30.3%), ROP (5.2% compared to 9%) and BPD (47.7% compared to 56.3%).