WIP 15 - Oral Feeding Practices in NICU Infants on Nasal CPAP or High Flow Nasal Cannula Support: A U.S. Cross-Sectional Survey

Publication Number: WIP 15.7594

Monica Koehler, University of Central Florida College of Medicine, Jacksonville, FL, United States; Shreyaashri Selvakumar, University of Central Florida, Lake Mary, FL, United States; Sreekanth Viswanathan, Nemours Children's Hospital, Orlando, FL, United States

Background: Non-invasive ventilation is frequently used in NICUs due to RDS and BPD. A survey done in Australia and New Zealand in 2019 found variation in feeding practices for infants, indicating differences in clinical opinion regarding swallow safety and aspiration risk, as well as lack of standardized clinical guidelines. This project aims to investigate the prevalence of oral feeding for infants receiving nCPAP and HFNC in NICUs across the USA.

Objective: To investigate the prevalence and practices of oral feeding among infants receiving nCPAP and HFNC, across the USA. This study aims to inform best practices and enhance clinical guidelines related to feeding in NICUs, ultimately improving the nutritional management and health outcomes of infants.

Design/Methods: This survey has IRB approval from Nemours Children's Health; labeled as Not Human Subjects Research. 105 survey responses are complete as of November 1, surveys will continue to March '25.
Level 3 and 4 NICUs listed on Neonatology Solutions' online NICU directory will be contacted via phone, a request will be made to speak to someone knowledgeable about the unit's feeding practices who is able to take a 5-10 minute survey:
1. Are infants who receive nCPAP PO fed?
2. What oral feeding methods are used? (Bottle or breast)
3. What strategies are used during feeding?
4. Who provides the oral feeds?
5. How does your unit define high flow?
6. Are infants who are receiving HFNC PO fed?
7. What oral feeding methods are used?
8. What strategies are used during feeding?
9. Who provides the feeds?
10. If participant answered “no” to 1; please explain.
11. If participant answered “no” to 6; please explain.
12. Are any evaluation tools used to assess feeding and swallowing?
13. Name and job title.

The surveyor records responses in a Google Form and exports the data to an Excel Spreadsheet. Responses will be analyzed to calculate feeding prevalence on nCPAP and HFNC, and analyze any regional variation. Once these statistics are calculated, descriptional analysis of feeding techniques and parameters will be done.