A major challenge-facing the 500,000 preterm infants born each year is the transition from gavage to oral feedings. Most preterm infants are bottle fed either formula or expressed breast milk while in the hospital. Thus, management of bottle feedings in preterm infants is a key aspect of hospital care. As there are few evidence-based protocols to guide clinicians in achieving competence at oral feeding, already vulnerable infants are subject to a trial-and-error approach to this complex and critical life-sustaining activity. This study builds on a National Institute of Nursing Research (NINR) funded study in which morbidity, maturity, and feeding experience predicted feeding outcomes. This study will prospectively test four different approaches to the transition to full oral feedings. The proposed study will provide important information about ways to assist preterm infants to make the transition from gavage to full oral feeding and how the transition may affect longer term development.
The specific aims of this application are to: 1)Test four approaches to oral feeding introduction and progression; 2) Test the effect morbidity, maturity, experience and behavior state on feeding outcomes in preterm infants; 3) Estimate the effect of feeding approaches on clinical outcomes; and 4) Estimate the effect of feeding approaches on feeding transition outcomes after discharge. The study aims are consistent with the NINR's efforts to establish a scientific basis for care of individuals across the life span. Specifically, the study will improve clinical care of preterm infants and will promote better clinical and health related outcomes of these children. A prospective, randomized, experimental design will be used to test four different approaches to the transition to full oral feedings. Data will be collected from infants during the 14 day approaches, at discharge, and 2-weeks post-discharge. Data will be analyzed using a mixed-models approach. Relevance: Over 500,000 preterm infants are born each year and feeding these infants is a major clinical challenge while they are in the hospital. How infants are fed during their hospitalization has long term consequences on health and development. This study will help nurses and families in neonatal intensive care units provide feeding care that may result in shorter hospital stays and improved developmental outcomes. ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR005182-06
Application #
7240571
Study Section
Special Emphasis Panel (ZRG1-HOP-D (02))
Program Officer
Bryan, Yvonne E
Project Start
2000-04-01
Project End
2011-04-30
Budget Start
2007-05-01
Budget End
2008-04-30
Support Year
6
Fiscal Year
2007
Total Cost
$406,739
Indirect Cost
Name
Virginia Commonwealth University
Department
Other Health Professions
Type
Schools of Nursing
DUNS #
105300446
City
Richmond
State
VA
Country
United States
Zip Code
23298
Tubbs-Cooley, Heather L; Pickler, Rita H; Meinzen-Derr, Jareen K (2015) Missed oral feeding opportunities and preterm infants' time to achieve full oral feedings and neonatal intensive care unit discharge. Am J Perinatol 32:1-8
Pickler, Rita H; Reyna, Barbara A; Wetzel, Paul A et al. (2015) Effect of four approaches to oral feeding progression on clinical outcomes in preterm infants. Nurs Res Pract 2015:716828
Cone, Sharon; Pickler, Rita H; Grap, Mary Jo et al. (2013) Endotracheal suctioning in preterm infants using four-handed versus routine care. J Obstet Gynecol Neonatal Nurs 42:92-104
Pickler, Rita H; McGrath, Jacqueline M; Reyna, Barbara A et al. (2013) Effects of the neonatal intensive care unit environment on preterm infant oral feeding. Res Rep Neonatol 2013:15-20
Pickler, Rita H; Reyna, Barbara A; Griffin, Junyanee Boonmee et al. (2012) Changes in Oral Feeding in Preterm Infants Two Weeks After Hospital Discharge. Newborn Infant Nurs Rev 12:202-206
Alberts, Jeffrey R; Pickler, Rita H (2012) Evolution and development of dual ingestion systems in mammals: notes on a new thesis and its clinical implications. Int J Pediatr 2012:730673
Williamson, Sarah; Munro, Cindy; Pickler, Rita et al. (2012) Comparison of biomarkers in blood and saliva in healthy adults. Nurs Res Pract 2012:246178
Pickler, Rita H; Martin, Alison T (2010) Protection of children in research. J Pediatr Health Care 24:66-8
Pickler, R H; Best, A; Crosson, D (2009) The effect of feeding experience on clinical outcomes in preterm infants. J Perinatol 29:124-9
Pickler, Rita H; Chiaranai, Chantira; Reyna, Barbara A (2006) Relationship of the first suck burst to feeding outcomes in preterm infants. J Perinat Neonatal Nurs 20:157-62

Showing the most recent 10 out of 17 publications