You’ve known this in your gut all along – trying to “get in” more volume when the infant is no longer interested or stable is not good or safe practice. You’ve known that feeding is really about the infant and family and not about us. But the old culture of the NICU did not leave much room for your gut, the evidence, or your knowledge.
Culture is all about unwritten rules and there are plenty of those in the NICU- especially related to feeding. It’s why newer neonatal therapists sometimes think they should ‘get in’ more volume than the nurses do or they’ll be perceived as not knowing what they’re doing. They think, “Can I call myself a feeding specialist or feeding champion if there are 7mls left in the bottle?” Both nurses and therapists can feel this way because it’s the NICU culture in which we were raised.
But as we create a new culture of oral feeding, we must identify the one we’re in, and the one we came from. Otherwise, we’ll unknowingly make the same mistakes and perpetuate a culture we’re actually quite ready to put away.
We give you permission to let go of what no longer serves you, the infant, or the family. In fact, we spend an entire chapter on it in our Online IDF Course. Here’s an inside look at just 1 page of the Change Culture chapter:
Advancing feeding practice is dependent on changing culture. Improving short and long term feeding outcomes requires both.
But first it requires a champion. Or a herd of them.
Let this be the day you’re no longer willing to tolerate the old culture. Let this be the day your NICU moves forward.