Research Corner: The Need for Psychometrically Validated Feeding Assessments in the NICU

Does the Infant-Driven Feeding Method Positively Impact Preterm Infant Feeding

Outcomes? Margaret Settle, PhD, RN, NE-BC; Kim Francis, PhD, RN, PHCNS-BC

Settle, M., & Francis, K. (2019). Does the Infant-Driven Feeding Method Positively Impact Preterm Infant Feeding Outcomes?. Advances in neonatal care: official journal of the National Association of Neonatal Nurses, 19(1), 51-55.


Background: Achievement of independent oral feeding is a major determinant of discharge and contributes to long lengths of stay. Accumulating evidence suggests that there is great variation between and within newborn intensive care units in the initiation and advancement of oral feeding. The Infant-Driven Feeding (IDF) method is composed of 3 behav­ioral assessments including feeding readiness, quality of feeding, and caregiver support. Each assessment includes 5 categories and is intended as a method of communication among caregivers regarding the infant’s

Findings: There were no randomized control, quasi-experimental, or retrospective studies utilizing the IDF method. There were 3 quality improvement projects utilizing the IDF method. The findings were conflicting: 1 project found the IDF method favorable in the achievement of full oral feedings, 2 projects found the IDF method favorable for reducing length of stay, and 1 project did not find differences in initiation, achievement of oral feedings, or length of stay.

Implications for Research: Research is needed to empirically validate the IDF method and to inform practice related to the initiation and advancement of oral feeding for preterm infants.

Commentary from  Catherine:  

The discussion section in the article states” Emerging evidence suggests that consistent oral feeding assessments may improve the preterm infant’s progression from gavage to full oral feeding and reduce the LOS. However, there is a lack of psychometrically tested feeding assessment tools. A comprehensive feeding assessment method that is psychometrically validated is needed to facilitate feeding progression for preterm infants.”

The Early Feeding Skills Assessment Tool developed by Thoyre , Shaker and Pridham is such a tool.

See: Thoyre, S. M., Pados, B. F., Shaker, C. S., Fuller, K., & Park, J. (2018). Psychometric Properties of the Early Feeding Skills Assessment Tool. Advances in Neonatal Care, 18(5), E13-E23.  See information on this publication in my June 2018 posts here on my website


Leave a Reply