National Survey of Gavage Feeding Practices Used in Very Low Birth Weight Infants

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The Ohio State University

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Purpose: To describe current gavage feeding practices for very low birth weight (VLBW) infants in newborn intensive care units (NICUs) throughout the United States, report nurse observed complications, and assess nursing beliefs about the evidence base supporting their gavage feeding practices. Subjects: One respondent from each of the 808 Level III NICUs in the United States. Design and Methods: Descriptive, survey design. The on-line survey comprised of 46 questions and additional pace for comments. Content validity of the survey was established by comparison with existing literature and review by an expert panel. The study was exempted from IRB review. Results: Surveys were received from 59 NICUs for a response rate of 7.25%. Significant variability was found across NICUs for gavage feeding practices. Practices that demonstrated the most variability included those surrounding gavage tube placement and maintenance. For example: four methods for measuring placement depth were identified, but no one method was used by more than one third of the units. The practice that demonstrated the least variability was frequency of tube placement, actions associated with infant discomfort and stress. Most units left feeding tubes in place rather than placing and removing them with each feeding. The most frequently reported complications associated with gavage feedings included reflux and tube mal-positioning. Eighty-six percent of the survey respondents believed that their unit’s gavage feeding practices reflected evidence-based practice. Conclusions: Wide variations in gavage feeding practices for VLBW infants were found. While nurses believe that their gavage feeding practices are evidence based, there is a paucity of empirical evidence. Research is needed urgently to identify the safest feeding practices.



Gavage, VLBW infant, tube feeding