Premature infants are at high risk for feeding problems, the leading cause for readmission once they’re discharged from the hospital. Feeding skills are developed during a period of rapid brain development after a baby is born. However, repeated negative experiences during initial feeding could lead to reluctance to acquire this essential skill. Clinicians have historically fed premature infants according to a schedule with a set feeding volume and time. Often, this method ultimately required using a feeding tube.

Intermountain’s Women and Newborns Clinical Program NICU Development Team lead the research and development of an infant-driven, cue-based feeding system that allows nursing staff to increase feeding opportunities using readiness cues from the baby. They chose to follow a modified Ludwig infant feeding scale to standardize communication about feeding readiness, feeding quality, and parent education. The new program also helped them standardize their approach to infant feeding cues and supportive feeding strategies; decrease length of stay; and improve parent satisfaction.

Cue-based feeding was launched at Utah Valley Hospital and resulted in a significant decrease in length of stay at all gestational ages. Cue-based feeding was rolled out system-wide in July 2015 in newborn, special care, and intensive care nurseries. Since a wider implementation of cue-based feeding, similar findings were achieved at other facilities. Notably, Intermountain Medical Center noticed a significant decrease in length of stay for extremely low birth weight infants.

Preterm infant cue-based feeding implementation results:

  • Median length of stay for 24-week gestation infants decreased from 129 days to 102 days
  • Median length of stay for 25-week gestation infants decreased from 121 days to 79.5 days