title: From tube to breast: the bridging role of semi-demand breastfeeding.
abstract: Determination of the optimal timing of breastfeeding initiation for preterm infants is still a challenge for health professionals. Often unjustified delays and restrictions of breastfeeding occur due to non-evidence-based current opinions about preterm infants' feeding capacity. Semi-demand feeding has been proposed for preterm infants during the transition from scheduled to full demand feeding, to promote the establishment of self-regulated oral feeding. Although semi-demand feeding has been shown to be safe and effective in reducing time to reaching oral feeding, the implementation of this feeding pattern for preterm infants in the neonatal intensive care unit (NICU) is still limited. We developed a protocol for the application of semi-demand feeding in preterm infants based on the existing knowledge of preterm infant neurodevelopment and NICU organization and staff experience. The protocol's aim is to attain successful transition from tube feeding to breastfeeding. In this article, we describe the protocol used in the neonatal unit of the Maternal and Child Health Institute of Trieste, a third level care center in northeastern Italy.
authors.affiliation: Department of Perinatal Medicine, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Davanzo
authors.affiliation: Department of Perinatal Medicine, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.
authors.forename: Tamara
authors.initials: T
authors.lastname: Strajn
authors.affiliation: Department of Perinatal Medicine, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Kennedy
authors.affiliation: Department of Perinatal Medicine, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Crocetta
authors.affiliation: Department of Perinatal Medicine, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy angela.decunto@libero.it.
authors.forename: Angela
authors.initials: A
authors.lastname: De Cunto
mesh_terms: D001942:Breast Feeding; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D007558:Italy; D000068101:Maternal-Child Health Services
keywords: NICU; breastfeeding; preterm; semi-demand feeding; tube feeding