Specialised medical professionals’ perspectives on oral feeding of infants and young children receiving high flow oxygen

Abstract

Background: Current research on the safety of oral feeding in infants and young children receiving high-flow oxygen therapy is limited, with differing views on decision-making in these cases. Aim: The aim was to explore perspectives of specialised medical professionals in South Africa regarding oral feeding practices of young children receiving high-flow oxygen therapy. Method: A 40-item electronic survey was completed by 37 South African specialised medical professionals. Non-probability, purposive sampling was used to recruit participants. Data were analysed descriptively. Results: The findings revealed varied perspectives on oral feeding practices for infants and young children on nasal continuous positive airway pressure (nCPAP) and high-flow nasal cannula (HFNC) oxygen therapy, with greater caution towards nCPAP due to higher perceived aspiration risks. Participants indicated a lack of guidelines (n=32; 97.0%) to follow regarding feeding practices with this population, with varied perspectives on oral feeding when on high-flow oxygen. Decisions are often made individually (n=15; 44.1%), but rarely made by a team. A cautious feeding approach monitoring clinical signs of aspiration was often (n=25; 78.1%) recommended with limited informal (n=13; 38.2%) and instrumental (n=12; 35.0%) assessment available and inconsistent SLT collaboration (n=9; 24.3%) despite access to SLT services (n=34; 79.4%). Conclusion: The study underscores varied approaches to oral feeding in infants and young children on high flow oxygen therapy among South African specialised medical professionals. The lack of research and established guidelines, and inconsistent use of formal measures to assess feeding, and limited multidisciplinary decisions are highlighted.