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Advances in Nutritional and Feeding Approaches in the Very Extreme...
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Advances in Nutritional and Feeding Approaches in the Very Extreme Preterm Infant Born Under 27 Weeks Gestation

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Neonatology".

Deadline for manuscript submissions: closed (20 May 2025) | Viewed by 1115

Special Issue Editor

Dr. Elizabeth Asztalos

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Guest Editor
Department of Newborn & Developmental Medicine, Sunnybrook Health Sciences Centre, Department of Paediatrics, University of Toronto, Toronto, ON M5A 1B2, Canada
Interests: neonatal care; neurodevelopmental outcomes; clinical trials; feeding and nutritional support
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Preterm birth continues to be a major health issue worldwide. Over the past few decades, there has been major gains in the care of the very small preterm infants, i.e., those born under 27 weeks. These are the infants at the highest risks of encountering both short- and long-term health outcomes. Infants born under 27 weeks gestation and younger are physiologically and developmentally immature, which can create challenges in regard to how care is often provided. An important area that is involved in aiding these immature infants is optimal nutritional support in order to promote and support brain growth development. It is hoped that optimal brain growth will lend itself to optimal functional neurodevelopmental outcomes. We also must support neurodevelopmental gains in the most vulnerable infants by ensuring supportive measures to aid in the most basic of tasks, such as feeding. The acquisition of feeding skills requires the coordination of the suck–swallow–breathe sequence and is influenced by many variables, including maturation, physiologic factors and environmental dynamics. In addition, we need to explore how we can optimize not only nutritional support but parental involvement in this area of care for extremely preterm infants.

I hope that this Special Issue will serve as an opportunity to look at how we can optimize this aspect of care for these infants and their parents.

Dr. Elizabeth Asztalos
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • extreme preterm infants
  • nutritional support
  • brain development
  • cue-based feeding
  • oral based feeding

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Published Papers (1 paper)

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14 pages, 2074 KiB  
Protocol
Systemizing and Transforming Preterm Oral Feeding Through Innovative Algorithms
by Rena Rosenthal, Jean Chow, Erin Sundseth Ross, Rudaina Banihani, Natalie Antonacci, Karli Gavendo and Elizabeth Asztalos
Children 2025, 12(4), 462; https://doi.org/10.3390/children12040462 - 3 Apr 2025
Viewed by 846
Abstract
Background: Establishing safe and efficient oral feeds for preterm infants is one of the last milestones to be achieved prior to discharge home. However, this process commonly elicits stress and anxiety in both care providers, such as nurses and the entire healthcare team [...] Read more.
Background: Establishing safe and efficient oral feeds for preterm infants is one of the last milestones to be achieved prior to discharge home. However, this process commonly elicits stress and anxiety in both care providers, such as nurses and the entire healthcare team in the Neonatal Intensive Care Unit (NICU), as well as parents. These feelings of uncertainty are exacerbated by the non-linear progression of oral feeding development and the absence of a systematized approach to initiate and advance feedings. Methods: In this 48-bed tertiary perinatal centre, staff surveys and a needs assessment showed dissatisfaction and increasing stress and anxiety due to the inconsistencies in initiating and advancing oral feeds. This paper describes the formation of a multidisciplinary feeding committee which reviewed various oral feeding training materials and the ultimate creation of two innovative oral feeding algorithms and their corresponding education materials. Results: The Sunnybrook Feeding Committee has developed two evidence-based algorithms, one for initiating oral feeds and another for monitoring progress with objective decision-making points during common oral feeding challenges. To complement and support these algorithms, educational materials and a comprehensive documentation process were also created. These resources included detailed instructions, visual aids, and step-by-step guides to help staff understand and apply the algorithms effectively. Additionally, the educational materials aimed to standardize training and ensure consistency across the NICU, further promoting a systematic approach to preterm oral feeding. Implementation of these algorithms also aimed to provide evidence-based, expert-guided guidelines for assessing readiness, initiating feeds, monitoring progress, and making necessary adjustments. Conclusions: This structured approach lays the foundation for a unit-wide language and systematic process for oral feeding. The next steps in this quality improvement project involve educating and piloting the implementation of the developed oral feeding algorithms, gathering staff feedback, and refining the tools accordingly. The goal is to enhance overall care quality, reduce stress for both care providers and parents, and ensure the best possible start for vulnerable preterm infants, ultimately supporting a smooth and successful transition to home. Full article
(This article belongs to the Special Issue Advances in Nutritional and Feeding Approaches in the Very Extreme Preterm Infant Born Under 27 Weeks Gestation)
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