Earlier Attainment of Full Nipple Feeds and Earlier Discharge Associated with Infant-Driven Feeding®

By Sue Ludwig and Kara Ann Waitzman

When we meet with people like you, neonatal professionals who are trying to advance feeding practice, you consistently ask for resources to support your efforts.

The resources may include a description of our online course, CEU information, referrals to other units using the IDF Model of Practice, the pricing tier, and of course, any literature or evidence that may be of interest to your leadership team.

To that end, we’d like to share the abstract to a 2015 article based on a quality improvement project in which great “take home” messages about IDF were presented.

1) The IDF approach was associated with significant reduction in time to full oral feeds and discharge (with attention to feeding quality).

2) The article addresses the vital cultural shifts that must occur to successfully change feeding practice and the multi-disciplinary nature of such a large undertaking. The IDF process was positively accepted by nurses, physicians, and therapists with 97% positive about the IDF approach and 92% favoring the IDF approach over a return to the practitioner-driven feeding.

3) The IDF Model of Care included not just the IDF Scales, but the very nature behind the practice – not pushing infants to feed when not showing cues. You will appreciate these two insightful notes on page 3 and 5 of the article:

“If a baby initially nipples well and then fatigues or becomes uncoordinated, the feeding is stopped and the remainder is gavage fed. The amount of milk taken by mouth and/or by gavage as well as Caregiver Techniques are also documented.

“Conversely, there were a few infants in the IDF cohort who initiated NF at a later PMA than would have been predicted (>35–36 weeks). Interestingly, when these infants eventually showed readiness, they quickly progressed to full feeds and were discharged soon thereafter (data not shown). In the PDF approach, such infants would have been expected to begin NF at a predetermined PMA, and ‘pushed’ to do so, even if not showing readiness.”

These statements exemplify the nature of the Infant-Driven Feeding Model of Practice’.

As with any literature, read the ENTIRE article, not just the highlights. Read and understand the limitations too, not just in the context of this project, but to understand why it’s quite difficult to conduct a RCT on such a visible and multi-faceted practice change.

The good news is, reduced length of stay, quicker time to oral feeds while attending to feeding quality, and staff satisfaction provide a win-win situation for babies, families, and NICU culture!

Here’s the link to the abstract: http://fn.bmj.com/content/early/2015/06/11/archdischild-2015-308296.short?rss=1

Should you need access to the other resources we mentioned above, simply follow the directions in #2 under the Resources section below and we’ll be happy to help.

*Please note that an updated version of the Infant-Driven Feeding Scales was published in 2014.