A National Survey on Oral Feeding Management Practices Across Canadian Neonatal Intensive Care Units.

Aim: To explore oral feeding management practices, specifically initiation and advancement of oral feeds, across level II and III neonatal intensive care units (NICUs) in Canada.

Methods: A national online survey was conducted across 65 NICUs (34 level II, 31 level III), which included questions on hospital demographics and clinical approaches for initiating, advancing, and managing oral feeds. A descriptive analysis was performed on the responses.

Results: Of the 65 NICUs surveyed, 74% ( = 48) completed the survey. Many reported using custom-developed NICU guidelines for initiating and advancing oral feeds ( = 22, 46%), while few used evidence-based protocols ( = 16, 33%) or standardized assessments ( = 1, 2%). The most common clinical factors considered for initiating and advancing oral feeds include, behavioral cues ( = 47, 98%), stable vital signs ( = 47, 98%), gestational age ( = 43, 90%), and suck-swallow-breathe coordination ( = 26, 54%). Most units utilized a multidisciplinary approach ( = 38, 79%) with family involvement ( = 38, 79%). Feeding issues were typically addressed only during hospitalization, with no post-discharge follow-up ( = 31, 65%).

Conclusion: This study revealed significant variation in oral feeding management practices across Canadian level II and III NICUs and highlights a shift toward evidence-based clinical factors for oral feeding initiation and advancement. These findings highlight the need for standardized, evidence-based guidelines to ensure consistent and optimal care in NICUs.