Sturm, L. D. (2005).Neonatal Network-The Journal of Neonatal Nursing,24(4), 21-25.

Should stable premature infants be discharged to home on gavage feedings? The American Academy of Pediatrics (AAP) Guidelines (AAP, 1999) recommend that prior to discharge, an infant must be capable of ingesting feedings orally without cardiorespiratory compromise. Some studies, however, have documented safe and successful transition to oral feedings in infants who were discharged home on gavage feeding programs (Evanochko et al., 1996;Kotagal, Perlstein, Gamblian, Donovan, & Atherton, 1995;Ortenstrand, Waldenstrom, & Windbladh, 1999). The purpose of this study by Sturm was to evaluate the safety of a home gavage program for premature infants in terms of weight gain, hospital readmission, parental satisfaction, and cost-effectiveness. Fifty-two infants participated in the study. Home nursing evaluations and feeding consultations were offered, as were home apnea/bradycardia monitoring and the availability of a home support person for families. Results were overwhelmingly positive, with an average daily weight gain of 31 g/day, no programmatic related hospital readmissions, parental reports of many program benefits, and an average cost savings for third-party payers of $12,428 per infant. Infants were discharged 10 to 12 days earlier than those not in the program. While the results of this study support that a home gavage feeding program is not only safe and cost-effective but also appreciated by parents, results may be limited in generalizability as only 36% of the 143 infants who met sampling criteria actually participated in the study, and it is not known if these infants were the most physiologically stable of the group. Further evaluation of such programs is warranted with careful attention to sampling criteria with strict guidelines for physiologic stability.

Comment by Judy Beal

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