Cue-Based Feeding in the NICU: Using the Infant’s Communication as a Guide

Abstract

Although studies have shown cue-based feeding can lead to earlier achievement of full oral feeding, the successful implementation of cue-based feeding has been constrained by the volume-driven culture, which has existed for many years in the NICU. This culture was built on the notion that a “better” nurse is one who could “get more in,” and infants who are “poor feeders” are ones who “can’t take enough.” The infant who feeds faster is often viewed as more skilled in this task-oriented approach.The feeding relationship and the infant’s communication about the experience of feeding may not be nurtured. This article will explain the central role of the preterm infant’s communication in successful cue-based feeding. When the infant is perceived as having meaningful behavior (i.e., communicative intent), the focus changes from a volume-driven to a co-regulated approach, through which the infant guides the caregiver. This is cue-based feeding.