Top 10 Goals of Successful Oral Feeding in the NICU

The first 4 goals below may sound familiar. Safe, functional, nurturing, and developmentally and individually appropriate are the foundational goals of Infant-Driven Feeding®. We’ve taught them for the past 17+ years.

Goals 5-10 are vital as well. We’ve added them here because confusion remains as to some of the basic tenants of successful feeding. While this list is not exhaustive, we believe that if an infant’s feeding experiences over his length of stay reflected each one of these goals, we would be well on our way toward advancing oral feeding practice on a global level – one baby, one feeding, one NICU at a time.

The goals are centered around oral feeding, but we cannot stress enough that optimal nutrition is primary, and the means by which infants receive that nutrition is secondary. Without good nutrition, multiple body systems are at risk, and some infants are simply unable (for many reasons) to transition to oral feeding. Nutrition remains primary.

Successful oral feeding is:

1. Safe.

• Safe from aspiration. Free of noxious or stressful interactions.

2. Functional.

• To us, this means that an infant is able to take in enough volume/calories for proper growth and nutrition WITHOUT undue stress on his body systems (all of them!). Sometimes, this involves a tube to meet goal #1.

3. Nurturing human interaction.

4. Developmentally and individually appropriate.

5. Focused on parent being first to feed with staff support.

6. Inclusive and supportive of breastfeeding if mother’s choice.

7. Driven by the infant’s stability, behavior, and feeding quality rather than staff and/or volume.

8. Implemented by a collaborative team from admission forward.

• Oral feeding may not begin for weeks or even months, but supporting optimal neurodevelopment begins DOL 1.

9. Evidence-based

• Evidence-based techniques are consistently used and old practices not supported in the literature are not used.

10. Objectively and succinctly documented

Babies should enjoy their feedings, not survive them. After all, we eat for life! Thank you for advocating on their behalf.