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Tool Helps Nurses Evaluate Premature Infants' Feeding Skills

Analysis  |  By Jennifer Thew RN  
   September 26, 2018

The Early Feeding Skills checklist accounts for the multiple skills infants need to feed successfully.

A key factor in determining when premature infants can be discharged home from the hospital is the establishment of oral feeding.  But for premature infants and those with medical problems during the neonatal period, learning to feed safely can be a challenge.

"For preterm infants and those with medical complexities, early feeding skills are in a state of emergence while receiving neonatal care. Selecting appropriate and supportive interventions begins with thorough assessment of the infant's skills," writes Suzanne Thoyre, PhD, RN, FAAN, of the University of North Carolina at Chapel Hill School of Nursing and her co-authors in new study in Advances in Neonatal Care.

Through their study, Thoyre and her colleagues determined the Early Feeding Skills checklist to be an effective way for nurses and other healthcare professionals to evaluate preterm infants' emergence of feeding skills.  

According to the research, the EFS is a user-friendly tool for assessing and monitoring feeding skills in premature infants and other infants at risk of feeding problems and for guiding interventions to promote the skills needed to successfully feed.  

The 22-item checklist can be used to assess oral feeding skills in infants feeding by breast or bottle. For the study, registered nurses, speech-language pathologists, and occupational therapists used the EFS to evaluate the feeding skills of 142 infants at children's hospitals in three states. Three-fourths of the infants were born prematurely while some were full-term infants who had undergone heart surgery.  

The researchers identified a set of five subscales measured by the EFS:

  1. Respiratory regulation (the ability to coordinate breathing and sucking)
  2. The ability to organize oral-motor function
  3. Swallowing coordination
  4. Staying engaged with feeding
  5. Remaining physiologically stable during feeding

Other assessments have focused on the volume of feeding or individual skills but did not account for the complexity and interaction of skills needed for effective feeding. 

"The EFS provides a reliable and valid way to systematically observe and record the maturation of [infants'] feeding skills and guides the selection of interventions to optimally support their skill trajectory," Thoyre and her colleagues conclude.

Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.

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