Oral Feeding Success: A Concept Analysis.

BACKGROUND: The term "oral feeding success" (OFS) is frequently used in clinical practice and research. However, OFS is inconsistently defined, which impacts the ability to adequately evaluate OFS, identify risk factors, and implement interventions in clinical practice and research. PURPOSE: To develop the defining attributes, antecedents, and consequences for the concept of OFS in preterm infants during their initial hospitalization. METHODS: PubMed, CINAHL, and PsycINFO databases were searched for English articles containing the key words "oral feeding success" and "preterm infants." The Walker and Avant method for concept analysis was employed. RESULTS: Sixteen articles revealed the defining attributes, antecedents, and consequences. Defining attributes included (1) physiologic stability; (2) full oral feeding; and (3) combined criteria of feeding proficiency (≥30% of the prescribed volume during the first 5 minutes), feeding efficiency (≥1.5 mL/min over the entire feeding), and intake quantity (≥80% of the prescribed volume). IMPLICATIONS FOR PRACTICE: The 3 defining attributes may be used in clinical practice to consistently evaluate OFS. The antecedents of OFS provide clinicians with a frame of reference to assess oral feeding readiness, identify risk factors, and implement effective interventions. The consequences of OFS allow clinicians to anticipate challenges when OFS is not achieved and create a care plan to support the infants. IMPLICATIONS FOR RESEARCH: The empirical referents of OFS provide consistent and clear operational definitions of OFS for use in research. The antecedents and consequences may guide researchers to select specific measures or covariates to evaluate valid measures of OFS.

Relationship Between Duration of Tube Feeding and Success of Oral Feeding in Preterm Infants.

OBJECTIVE: Primary: to identify the potential relationship between duration of tube feeding and success of oral feeding in preterm infants; secondary: to identify the potential relationships among duration of tube feeding and alert behavioral states, orally directed behaviors, and nutritive sucking. DESIGN: A descriptive correlational study. SETTING: A Level III NICU at an inner-city hospital. PARTICIPANTS: Twenty-eight preterm infants who were born between 28 and 32 weeks gestational age, were clinically stable, and were expected to have at least 1 week of tube feeding during their initial hospitalizations. METHODS: Data were collected daily from participants' electronic medical records and at one-time oral feeding evaluations within 48 hours after the removal of the feeding tube. RESULTS: We found a significant negative correlation between duration of tube feeding and oral feeding success (p = .000). We found no correlations between duration of tube feeding and alert behavioral states, orally directed behaviors, or nutritive sucking. CONCLUSION: Although the duration of tube feeding is a nonmodifiable factor, preterm infants who are anticipated to have extended durations of tube feeding may be at risk for delayed oral feeding success.