Placing the bottle or breast in their premature hands: A review of cue-based feeding research

Infants in the Neonatal Intensive Care Unit (NICU) frequently experience a delay in the initiation of oral feedings, related either to illness or prematurity, and demonstrate greater difficulties transitioning from gavage to oral feedings. Given the demonstration of physiologic stability, these infants would benefit from a shorter length of stay which would minimize parental-infant separation and exposure to possible hospital-acquired infections. However, current practice is inconsistent, at best, and is based largely on both prior experiences and NICU culture rather than on evidence-based practices. A systematic review of the literature pertaining to a “cue-based” feeding approach that initiates and advances oral feedings in the premature population and the impact it has on length of stay, weight gain, and caregiver satisfaction was performed.