Oral feeding practices in medically complex infants receiving prolonged high-flow nasal cannula support: A retrospective cohort study

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First published online 04 October 2023

Why this study was done

Some babies with complex medical needs need extra help to breathe using a device called a high-flow nasal cannula (HFNC) for a long period of time. Doctors and nurses are not always sure of the safest way to feed these babies while they are on HFNC, and different hospitals handle this in different ways. This study examined how feeding was managed for these infants at a large children’s hospital in Australia.

What the study did

Researchers reviewed the medical records of 24 medically complex babies treated at Queensland Children’s Hospital in 2021. All of the babies had been supported with HFNC for at least five days. The researchers collected information about the babies’ medical conditions, how long they required HFNC, the types of feeding used, and the involvement of speech pathologists in their care.

What the study found

  • Babies stayed on HFNC for a long time (median of 37.5 days).
  • Most (83%) were referred to speech pathology for feeding help.
  • HFNC was often seen as a reason not to try oral feeding.
  • Feeding methods varied a lot between babies.
  • At discharge, only 2 babies (9%) were fully feeding by mouth; most still needed tube feeds.

What this means

Feeding practices for babies who need long-term HFNC are not consistent, even within the same hospital. Because HFNC is often seen as a barrier to feeding, many babies miss opportunities to practise feeding by mouth. Clear, evidence-based feeding guidelines are needed to help healthcare teams feed babies safely and consistently, and to improve outcomes for these vulnerable infants.

This study was conducted by:

Dr Emily Cox, Dr. Jasneek Chawla, Ms Madison Moore, Ms Sandra Schilling, Dr Mirian Cameron, Ms Sally Clarke, Ms Chelsea Johnstone and Dr Jeanne Marshall.

To read the full article, visit the journal.

For other accessible formats, please see the column to the right.

Disclaimer: The QDRN has utilised generative AI to refine the wording of this plain language summary. All content has been checked for accuracy, appropriate tone and clarity and approved by the author.

First published online 04 October 2023

Why this study was done

Some babies with complex medical needs need extra help to breathe using a device called a high-flow nasal cannula (HFNC) for a long period of time. Doctors and nurses are not always sure of the safest way to feed these babies while they are on HFNC, and different hospitals handle this in different ways. This study examined how feeding was managed for these infants at a large children’s hospital in Australia.

What the study did

Researchers reviewed the medical records of 24 medically complex babies treated at Queensland Children’s Hospital in 2021. All of the babies had been supported with HFNC for at least five days. The researchers collected information about the babies’ medical conditions, how long they required HFNC, the types of feeding used, and the involvement of speech pathologists in their care.

What the study found

  • Babies stayed on HFNC for a long time (median of 37.5 days).
  • Most (83%) were referred to speech pathology for feeding help.
  • HFNC was often seen as a reason not to try oral feeding.
  • Feeding methods varied a lot between babies.
  • At discharge, only 2 babies (9%) were fully feeding by mouth; most still needed tube feeds.

What this means

Feeding practices for babies who need long-term HFNC are not consistent, even within the same hospital. Because HFNC is often seen as a barrier to feeding, many babies miss opportunities to practise feeding by mouth. Clear, evidence-based feeding guidelines are needed to help healthcare teams feed babies safely and consistently, and to improve outcomes for these vulnerable infants.

This study was conducted by:

Dr Emily Cox, Dr. Jasneek Chawla, Ms Madison Moore, Ms Sandra Schilling, Dr Mirian Cameron, Ms Sally Clarke, Ms Chelsea Johnstone and Dr Jeanne Marshall.

To read the full article, visit the journal.

For other accessible formats, please see the column to the right.

Disclaimer: The QDRN has utilised generative AI to refine the wording of this plain language summary. All content has been checked for accuracy, appropriate tone and clarity and approved by the author.