Inadequate oral feeding as a barrier to discharge in moderately preterm infants

Laura Edwards; C Michael Cotten; P Brian Smith; Ronald Goldberg; Shampa Saha; Abhik Das; Abbot R Laptook; Barbara J Stoll; Edward F Bell; Waldemar A Carlo; Carl T D'Angio; Sara B DeMauro; Pablo J Sanchez; Seetha Shankaran; Krisa P Van Meurs; Betty R Vohr; Michele C Walsh; William F Malcolm; Eunice Kennedy Shriver National Institute of Child Health and Human Development

doi:10.1038/s41372-019-0422-x

Inadequate oral feeding as a barrier to discharge in moderately preterm infants

J Perinatol. 2019 Sep;39(9):1219-1228. doi: 10.1038/s41372-019-0422-x. Epub 2019 Jul 11.

Authors

Laura Edwards^{1

2}, C Michael Cotten¹, P Brian Smith¹, Ronald Goldberg¹, Shampa Saha³, Abhik Das⁴, Abbot R Laptook⁵, Barbara J Stoll⁶, Edward F Bell⁷, Waldemar A Carlo⁸, Carl T D'Angio⁹, Sara B DeMauro¹⁰, Pablo J Sanchez¹¹, Seetha Shankaran¹², Krisa P Van Meurs¹³, Betty R Vohr⁵, Michele C Walsh¹⁴, William F Malcolm¹⁵; Eunice Kennedy Shriver National Institute of Child Health and Human Development

Affiliations

¹ Department of Pediatrics, Duke University, Durham, NC, 27708, USA.
² WakeMed Health and Hospitals, Raleigh, NC, 27610, USA.
³ Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, NC, 27709, United States.
⁴ Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, MD, 27709, USA.
⁵ Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI, 02912, USA.
⁶ Department of Pediatrics, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, 30322, USA.
⁷ Department of Pediatrics, University of Iowa, Iowa City, IA, 52242, USA.
⁸ Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.
⁹ University of Rochester School of Medicine and Dentistry, Rochester, NY, 14642, USA.
¹⁰ Department of Pediatrics, The Children's Hospital of Philadelphia, The University of Pennsylvania, Philadelphia, PA, 19104, USA.
¹¹ Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, 43205, USA.
¹² Department of Pediatrics, Wayne State University, Detroit, MI, 48202, USA.
¹³ Department of Pediatrics, Division of Neonatal and Developmental Medicine, Lucile Packard Children's Hospital, Stanford University School of Medicine, Palo Alto, CA, 94305, USA.
¹⁴ Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, 44106, USA.
¹⁵ Department of Pediatrics, Duke University, Durham, NC, 27708, USA. william.malcolm@duke.edu.

Abstract

Objectives: The objectives describe the frequency that inadequate oral feeding (IOF) is the reason why moderately preterm (MPT) infants remain hospitalized and its association with neonatal morbidities.

Study design: Prospective study using the NICHD Neonatal Research Network MPT Registry. Multivariable logistic regression was used to describe associations between IOF and continued hospitalization at 36 weeks postmenstrual age (PMA).

Result: A total of 6017 MPT infants from 18 centers were included. Three-thousand three-seventy-six (56%) remained hospitalized at 36 weeks PMA, of whom 1262 (37%) remained hospitalized due to IOF. IOF was associated with RDS (OR 2.02, 1.66-2.46), PDA (OR 1.86, 1.37-2.52), sepsis (OR 2.36, 95% 1.48-3.78), NEC (OR 16.14, 7.27-35.90), and BPD (OR 3.65, 2.56-5.21) compared to infants discharged and was associated with medical NEC (OR 2.06, 1.19-3.56) and BPD (OR 0.46, 0.34-0.61) compared to infants remaining hospitalized for an alternative reason.

Conclusion: IOF is the most common barrier to discharge in MPT infants, especially among those with neonatal morbidities.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Bottle Feeding
Breast Feeding
Energy Intake*
Feeding Behavior*
Feeding Methods
Female
Humans
Infant
Infant, Newborn
Infant, Premature*
Logistic Models
Male
Patient Discharge*
Prospective Studies
Respiratory Distress Syndrome, Newborn
Sepsis

Abstract

Publication types

MeSH terms

Grants and funding