Nipple feeding premature infants in the neonatal intensive-care unit: factors and decisions.

OBJECTIVE

To rank factors considered important by neonatal intensive-care unit (NICU) nurses in identifying hunger in infants weighing 1,800 g or less, to rank factors considered important in making decisions about nipple feeding such infants, to determine whether the two rankings varied among hospitals, and to identify the caregiver with the greatest influence over feeding decisions.

DESIGN

Descriptive comparative survey.

SETTING

NICUs of three metropolitan hospitals.

PARTICIPANTS

Forty-seven NICU nurses in those hospitals.

MAIN OUTCOME MEASURES

Nurses ranked factors indicating hunger in preterm infants and factors contributing to feeding decisions for such infants.

RESULTS

Vigorous sucking, rooting, and crying were ranked as hunger cues. Nonnutritive sucking and a gestational age of 34 weeks or more were considered indicators of readiness to begin nipple feeding. The centrality of the nurse's role in feeding decisions was confirmed.

CONCLUSIONS

Additional research is needed to determine whether nonnutritive sucking predicts nutritive sucking performance and to study the nurses' responses to infants who suck poorly or refuse to nipple feed.