Commentary - Current Pediatric Research (2024) Volume 28, Issue 8

Importance of swallow assessment for preterm/high risk neonates important in NICU

Sheikh Shakhbout Medical City (SSMC), which was established in 2020, has made its footprint on the national and the regional stage as one of the largest hospitals providing world-class holistic healthcare service. In SSMC Neonatal Intensive Care Unit (NICU) is a Level-3 unit with 26 ICU cots managing complex medical and surgical neonatal cases including extreme premature babies as early as 22 weeks of gestation. Managing premature infants is a specialised field and challenging to clinicians as well as families due the complications post-delivery secondary to immaturity of body organs and their functions.

One of the specialized services provided at SSMC is swallow assessment and rehabilitation of feeding difficulties for preterm babies as well as high risk full term babies in NICU. This service was initiated in 2020 completely established in 2022 to till date with the support of Dr. Faisal Al Zidgali Chair of Neonatology along with Taniya Raj Senior Speech Language Pathologist (SLP).

Background: SLP at SSMC works as a part of NICU multidisplinary team and collaborates closely with physicians, nurses and lactation consultant nurses in weaning enteral feeds and achieving full oral feeding with no secondary complications such as aspiration for preterm and high risk babies. The clinical significance of this service includes the followings:

• This is a unique service in UAE providing comprehensive approach of assessing and screening all preterm and at risk neonates for swallowing abilities which helps to minimize aspiration risk with oral feeds.

• This is a proactive and preventative approach where all preterm babies are referred to SLP before they become symptomatic with aspiration from oral feeding due to the swallow breathe incoordination.

• The service delivery encourages and supports breastfeeding by working closely with lactation team.

• Parents are educated on safe feeding strategies while oral feeding their babies during NICU stay thereby ensuring safe home discharge of these high-risk preterm babies.

• Reduces hospital readmission post-discharge due to aspiration or oral feeding difficulties.

• This is a high quality service with improvement measures in clinical outcome, patient safety and family centered patient care.

The study concluded that feeding related complications and aspiration in preterm, term infants in NICU can be minimized with early identification of penetration or aspiration signs during the oral feeding rehabilitation provided by the SLP from 33 weeks of corrected gestation age. SLP’s working in the NICU provides great contribution to train mothers/caregivers before discharge on safe feeding strategies to minimize aspiration while oral feeding post discharges.

Author(s):

Taniya Raj, Faisal Al Zidgali

Abstract PDF