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Abstract

There is international uncertainty and little guidance regarding oral feeding on nasal continuous positive airway pressure (nCPAP) and high-flow nasal cannula (HFNC) respiratory support. The aim of this study is to investigate current practice in the UK when deciding to offer oral feeds to infants on nCPAP/HFNC. A novel survey was designed and conducted using Qualtrics. Purposive sampling was used to recruit participants in speech and language therapy, medicine and nursing via professional associations. Participants completed the 41-item survey which explored oral feeding practices for infants on nCPAP/HFNC. The survey included closed-choice and open-ended questions. Descriptive statistics using SPSS, were used to analyse quantitative findings. A frequency count and thematic analysis were used to describe qualitative data. 103 responses were analysed. Regarding frequency of oral feeding on nCPAP, most respondents (45%) never fed; 30% rarely fed; 21% sometimes fed; 3% often fed, and 1% always fed (
n
 = 73). Regarding HFNC, most respondents (48%) sometimes fed; 23% often fed; 1% always fed and 28% never or rarely fed (
n
 = 69). 58% of respondents followed no guidelines when making decisions regarding oral feeding on nCPAP/HFNC, and 42% did or had guidelines in development (
n
 = 83). Qualitative analysis identified the importance of the multidisciplinary team (MDT), infant readiness and the evidence-base when orally feeding an infant on nCPAP/HFNC. A continuum of conflict was acknowledged ranging from agreement amongst the MDT to disagreement within and between disciplines. More clinicians feed on HFNC than on nCPAP and there is little in the way of guidelines to support decision-making leading to variation in practice. Further research is recommended, including empirical studies using instrumental assessment of swallow safety, to guide clinicians with their decision-making.

Publication Type:	Article
Additional Information:	This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Publisher Keywords:	Newborn, Suck-feeding, Deglutition, Non-invasive ventilation
Subjects:	R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
Departments:	School of Health & Medical Sciences School of Health & Medical Sciences > Department of Allied Health
SWORD Depositor:	Symplectic Administrator

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