by Sue Ludwig and Kara Ann Waitzman
Every day, you’re asked to bridge the gap between staff and families regarding oral feeding practice in the NICU. While you welcome this role, it’s a difficult one to fulfill when no one is on the same page about the goals of the practice itself.
Does trying to improve your NICU’s long-standing and perhaps outdated practice frustrate you? Are you pulling your hair out because you’ve tried over and over to implement a more neurodevelopmental feeding approach and continue to run into brick walls? Do you almost fall over when someone asks you if there’s any evidence for moving away from the old ‘PO once a day, twice a day, once a shift’ type practice?
You’re not alone.
In fact, we have been exactly where you are. That’s why we’ve spent the last 17 years or so addressing the 5 most common issues below. (Yes, the neonatal world has been talking about these same issues for at least that long.)
Why is it so difficult to change? There are many reasons we’d be happy to share with you, but let’s begin here:
5 Challenging Aspects of Changing NICU Feeding Practice:
- Traditional oral feeding practice has existed, well, since the beginning. (The beginning of NICUs. Forever.) Changing the status quo is always the result of high intention and valiant effort.
- It is highly cultural. This means that you not only have to change the practices related to feeding, you have to change how everyone thinks about feeding and the multitude of habits they’ve developed around it. This is a tall order.
- It can be challenging to educate 100+ staff in a deep and multifaceted practice then ensure everyone really ‘gets it’ and will teach families in a consistent way.
- While we all believe infants should be fed using an infant-driven, neurodevelopmental approach, implementing that concept in a way that the staff LOVES versus dreads used to seem impossible.
- You care about improving feeding so much that you want the transformation to happen ASAP. And nothing this big happens overnight. You get frustrated. You rarely have enough support or time. You’re on a roller coaster and ALL YOU WANT is for babies to have the feeding experiences they deserve. You want families to be empowered, informed, and expert at feeding their children.
Being a feeding champion is challenging because it takes significant endurance and resilience. If you give up or move to a different unit, your NICU’s progress may be reset to zero until another champion picks up the torch and begins again. We’ve seen units lose years of progress when no sustainable program was in place.
All of these issues are real. You’re not imagining them!
The great news? We have done the groundwork for you.
It’s time for babies to stop surviving their feedings and start enjoying them.