Inconsistent Practice Produces Inconsistent Results

By Sue Ludwig and Kara Ann Waitzman

Yes, feeding champions, you are correct. Traditional feeding practices are simply inconsistent. For example, we see significant variations within and between NICUs regarding:

  • What it looks like to provide neurodevelopmental support from admission forward
  • Skin-to-skin practices
  • Criteria used to initiate and support breastfeeding and/or bottle feeding
  • Criteria used to determine advancement of oral feeding
  • Criteria for moving to ad lib on demand
  • Documentation and practices surrounding assessment of feeding readiness, feeding quality, and caregiver techniques
  • Knowledge base upon which caregivers assess and make decisions surrounding feeding and swallowing
  • Language associated with feeding
  • Language and practices surrounding parent education about feeding
  • Equipment selection
  • Feeding culture
  • Provider input and support

​​​​​​​This inconsistency stems in part from a lack of a clearly defined model of practice for oral feeding and lack of consistent staff education. Therefore, many of the decisions made about oral feeding are highly subjective, not agreed upon by all team members, and not carried out. This provides the infant with inconsistent feeding experiences and results in parental frustration and confusion.

The IDF Model of Practice was born out of the need to provide a replicable structure. It is family centered, neurodevelopmental at its core, and infant-driven (meaning the infant’s stability, behavior, and maturity drives the practice). The assessments and documentation used in the IDF Model of Practice improve objectivity and consistency; it’s a team-oriented approach that focuses on long term feeding success for the infant and family.

How can a unit best go about getting everyone on the same page so that practice can become consistent, reliable, appropriate and supportive of the transition to oral feeding?

We have led thousands of neonatal caregivers toward improving oral feeding practices for over a decade. We believe change of this magnitude can only be accomplished by providing unit-wide education to every single bedside caregiver and all new orientees. Otherwise, the practice erodes over time. Even the naysayers need to know how to best support feeding practice. This isn’t just about how to feed a baby. It’s a complete shift in culture and practice.

But unit-wide education isn’t as easy as it sounds right? How can 50-200+ professionals wrap their brains around such a deep and multi-faceted topic with any consistency?

We have a way!

If you’d like to learn the entire IDF Model of Practice in an online course and vet the content for your NICU, click here to take the course today. Then simply set up a call with us (see link to our calendars below) to learn more about pricing and implementation for unit-wide education for your NICU staff. We have done this work in hopes of saving you hours upon hours of time, energy, and frustration while setting infants and families up for a successful transition to oral feeding.

Consistent practice and education leads to consistent patient and family outcomes.