Feeding practices within neonatal intensive care units in tertiary public hospitals in Gauteng.

Background: Before discharge from the Neonatal Intensive Care Unit (NICU), it should be a prerequisite for the infant to achieve safe oral feeding (Lau, 2014). Some infants experience difficulty with oral feeding post-discharge and many return to the hospital with complications (Lubbe, 2018). These complications and feeding difficulties could be attributed to the troublesome transition to oral feeds within the NICU or the lack of support in NICUs during feeding times. Which could have been further influenced due to the novel COVID-19 global pandemic. Aim: The aim of this study was to describe the feeding practices and the role of the healthcare workers involved in feeding in the Neonatal Intensive Care Units in two tertiary hospitals in Gauteng. Design: Structured observations were done over a period of 17 days and 22 semistructured interviews with healthcare workers working within the NICU were conducted. Interviews were analysed qualitatively using a deductive thematic analysis approach. Findings: Most infants admitted to the Neonatal Intensive Care Units are initially fed by enteral and alternative feeding methods. Public NICUs have a shortage of healthcare workers to assist the infants who are admitted to successfully transition to oral feeds before discharge. Furthermore, COVID-19 seems to have influenced the overall workload of healthcare workers and therefore possibly limited the quality of service provided in terms of feeding development of the infants. Conclusion: With more healthcare workers and dedicated developmental team members within the NICU who understand their primary or secondary role within feeding, the feeding development of infants can be supported optimally and guided safely in order to discharge infants successfully and ultimately decrease neonatal deaths.
A dissertation submitted in fulfilment of the requirements for the degree Master of Arts in Speech Pathology to the Faculty of Humanities, University of the Witwatersrand, 2021