I am proud to announce the publication of my two new manuscripts devoted to Infant-Guided Feeding in the NICU. I was invited to contribute regarding the NICU for the 25th anniversary edition of Seminars in Speech and Language, dedicated to Pediatric Feeding and Swallowing. I am humbled to be one author amongst colleagues well-respected in pediatric dysphagia. My goal was to share the science and art that underlies our role as skilled and thoughtful neonatal therapists. A sequel to my previous papers on using the infant’s communication as a guide during feeding and supporting parents in feeding their preterm infant, these contributions are designed to provide the theoretical underpinnings and interventions that are foundational in the Neonatal Intensive Care Unit. Support of an infant guided, co-regulated feeding approach is essential to both neuroprotection and safety for these infants who are entrusted to our care. I hope they inform your practice and extend your critical thinking with our tiniest and most fragile patients.

Below are the citations and abstracts:

Shaker CS. Infant-Guided, Co-Regulated Feeding in the Neonatal Intensive Care Unit. Part I: Theoretical Underpinnings for Neuroprotection and Safety. Semin Speech Lang. 2017 Apr;38(2):96-105. doi: 10.1055/s-0037-1599107. Epub 2017 Mar 21.

Abstract: The rapid progress in medical and technical innovations in the neonatal intensive care unit (NICU) has been accompanied by concern for outcomes of NICU graduates. Although advances in neonatal care have led to significant changes in survival rates of very small and extremely preterm neonates, early feeding difficulties with the transition from tube feeding to oral feeding are prominent and often persist beyond discharge to home. Progress in learning to feed in the NICU and continued growth in feeding skills after the NICU may be closely tied to fostering neuroprotection and safety. The experience of learning to feed in the NICU may predispose preterm neonates to feeding problems that persist. Neonatal feeding as an area of specialized clinical practice has grown considerably in the last decade. This article is the first in a two-part series devoted to neonatal feeding. Part 1 explores factors in NICU feeding experiences that may serve to constrain or promote feeding skill development, not only in the NICU but long after discharge to home. Part II describes approaches to intervention that support neuroprotection and safety.

Shaker CS. Infant-Guided, Co-Regulated Feeding in the Neonatal Intensive Care Unit. Part II: Interventions to Promote Neuroprotection and Safety. Semin Speech Lang. 2017 Apr;38(2):106-115. Epub 2017 Mar 21.

Abstract: Feeding skills of preterm neonates in a neonatal intensive care unit are in an emergent phase of development and require careful support to minimize stress. The underpinnings that influence and enhance both neuroprotection and safety were discussed in Part I. An infant-guided, co-regulated approach to feeding can protect the vulnerable neonate’s neurologic development, support the parent-infant relationship, and prevent feeding problems that may endure. Contingent interventions are used to maintain subsystem stability and enhance self-regulation, development, and coping skills. This co-regulation between caregiver and neonate forms the foundation for a positive infant-guided feeding experience. Caregivers select evidence-based interventions contingent to the newborn’s communication. When these interventions are then titrated from moment to moment, neuroprotection and safety are fostered.

Catherine