title: Feed-Thickening Practices in NICUs in the Current Era: Variability in Prescription and Implementation Patterns.
abstract: BACKGROUND
  Feed-thickening for infants in the Neonatal Intensive Care Unit (NICU) is performed due to concerns of dysphagia and gastroesophageal reflux disease (GERD). No standards currently exist regarding feed-thickening prescriptions and practices and this results in variable and potentially unsafe feeding approaches.
  
  
  METHODS
  Electronic surveys were sent to neonatal feeding therapists and providers in order to determine the prescriptions and practices currently being used for feed-thickening in the NICU.
  
  
  RESULTS
  A total of 313 responses were collected. Results revealed the majority of providers use thickened feeds for concerns of dysphagia or GERD with some reporting they thicken expressed breast milk. Variability of thickening prescriptions was noted regarding consistencies, thickening agents, and recipes used. Reported approaches for measuring, mixing, and warming thickened feeds varied.
  
  
  CONCLUSIONS
  Variability was noted in the feed-thickening prescriptions and practices performed in the NICU. Further research and standardization are required to develop thickening guidelines.
authors.affiliation: The Neonatal and Infant Feeding Disorders Program, Center for Perinatal Research, Innovative Infant Feeding Disorders Research Program, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Lauren L
authors.initials: LL
authors.lastname: Madhoun
authors.affiliation: The Neonatal and Infant Feeding Disorders Program, Center for Perinatal Research, Innovative Infant Feeding Disorders Research Program, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Kimberly K
authors.initials: KK
authors.lastname: Siler-Wurst
authors.affiliation: The Neonatal and Infant Feeding Disorders Program, Center for Perinatal Research, Innovative Infant Feeding Disorders Research Program, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Swetha
authors.initials: S
authors.lastname: Sitaram
authors.affiliation: The Neonatal and Infant Feeding Disorders Program, Center for Perinatal Research, Innovative Infant Feeding Disorders Research Program, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA ; Division of Neonatology, Pediatric Gastroenterology and Nutrition, Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA.
authors.forename: Sudarshan R
authors.initials: SR
authors.lastname: Jadcherla
keywords: Dysphagia; Gastroesophageal reflux; Neonates; Thickened feeds