Feeding characteristics and influencing factors of high-risk neonates in the NICU environment
FAN Dan-xia
YANG Wen
LI Wen-hui
LE Wen
ZHANG Xiao-ying
XIE Yun-lan
WANG Xiao-jie
XU Kai-shou
Abstract：Objective To investigate the feeding characteristics of high-risk neonates in the neonatal intensive care unit(NICU)and to identify associated influencing factors.Methods A cross-sectional study was conducted using a convenience sampling method.From January to September 2024,141 high-risk neonates admitted to the National Re-gional Children's Medical Center NICU were assessed using the Neonatal Eating Outcome Assessment(NEO)scale.The Wilcoxon signed-rank test,Kruskal-Wallis test,and binary logistic regression were applied to analyze feeding charac-teristics and key influencing factors.Results Among the 141 high-risk neonates,52(36.9％)exhibited feeding prob-lems or difficulties.The total NEO score and all dimension scores were significantly lower in the feeding-difficulty group compared with the normal group.Physiological stability(OR=1.119,95％CI:1.114-1.723),sucking initiation(OR=0.945,95％CI:1.015-2.270),non-nutritive sucking(OR=1.105,95％CI:1.269-1.757),sucking qual-ity(OR=1.508,95％CI:1.048-2.169),behavioral response(OR=2.159,95％CI:1.462-3.190),respiratory control(OR=1.335,95％CI:1.097-1.624),state maintenance(OR=1.231,95％CI:1.075-1.410),and con-sumption(OR=1.728,95％CI:1.056-2.827)were identified as the major influencing factors(P＜0.05).Infants with birth weight ≥2 500 g scored higher in tongue movement,non-nutritive sucking,and sucking burst length compared with those weighing 1 500-2 500 g(P＜0.05),and had higher non-nutritive sucking scores than those＜1 000 g(P＜0.05).Current weight 2 501-4 000 g was associated with higher scores in tongue movement,non-nutritive suck-ing,sucking burst length,and fluid loss compared with 1 600-2 500 g(P＜0.05).Infants with gestational age 34-36 weeks showed higher feeding behavioral response scores than those＜28 weeks.Postmenstrual age(PMA)37-40 weeks was associated with higher scores in tongue movement,suck-swallow-breathe coordination,sucking burst length,suck-ing quality,feeding behavior,and post-feeding observation compared with 33-36 weeks(P＜0.05);PMA＞40 weeks had higher non-nutritive sucking,sucking burst length,sucking quality,swallowing,state maintenance,and consump-tion scores(P＜0.05).Sucking burst length correlated positively with birth weight(r=0.400)and PMA(r=0.450),with no other significant correlations observed.Conclusion High-risk neonates in the NICU with greater birth and cur-rent weights(particularly ≥2 500 g)and more advanced postmenstrual age(especially ≥ 37 weeks)demonstrated better core feeding functions such as tongue movement,non-nutritive sucking,and sucking burst length.Targeted and system-atic interventions should be developed based on these influencing factors to improve feeding outcomes in high-risk neo-nates.
Keywords：high-risk neonatefeeding behaviorneonate intensive care unitneonatal eating outcome assess-ment scalebody weight
Publication Date：2025-12-15
Online Publishing Date：2026-01-12(First online date of this platform, not the publication date of the document)
Pages：9( 1888-1896 )