Cue-based feeding and short-term health outcomes of premature infants in newborn intensive care units: a non-randomized trial

Background: Feedings based on behavioral cues is a method relying on infants' behavioral expressions of readiness to feed. The objective of this interventional study was to determine the effect of cue-based feeding on the short-term health outcomes of preterm infants. Methods: This quasi-experimental study utilized a historical or phase lag design. It involved 60 preterm infants admitted to an Iranian referral hospital's Level III-Newborn Intensive Care Unit (NICU) from April 2017 until January 2018. The experimental group (n= 30) received a three-step intervention of offering behavioral-cue-based oral (BCBO) feedings: Step 1 - One BCBO feeding every 12 hours for 3 days; Step 2 -Two BCBO feedings every 12 h for 3 days; and Step 3 - All feedings as BCBO feedings for 3 days. The control group received standard care feedings. Group difference data were analyzed with SPSS version 16 using descriptive and inferential statistics. Results: The infants' mean weight at time of discharge for the intervention and control groups were 1492.79 +/- 21.65 g and 1395.71 +/- 17.61 g (P=.003) respectively. The mean durations of achieving full oral feedings in the intervention and control groups were 17 +/- 6 and 20 +/- 11 days, respectively (P = .19). The mean frequencies of hypoxia were 1 +/- 1.54 and 5 +/- 9.31 respectively (P = .03) and of gavage feedings 725 +/- 584 and 1846 +/- 2097 respectively (P= .009). No apnea events were reported for the intervention group; the frequency of apnea in the control group was 1 +/- 2.11 (P = .16). Conclusion: The findings indicate that cue-based feeding is beneficial for preterm infants.Therefore, it is recommended that nurses employ cue-based feeding in the NICU.