Receiving facility-based rehab services for feeding issues via OT +/or ST at time of discharge
Receiving supplemental TF’s d/t inability to support caloric goals via PO alone
Family requires ongoing support to ensure the infant is receiving proper strategies to match skill
Medical history/diagnosis that impacts typical development such as Neurological, pulmonary,
gastric motility issues, that could impact feeding success and at risk for rehospitalization
NAS infants with h/o concerning NAS scores 2/2 substance abuse, ETOH, methadone etc. as
these chemicals alter neurological pathways, sensory learning and can impact feeding
Craniofacial abnormalities such as cleft palate
Abnormal tone that can impact feeding, h/o seizures or abnormal CUS/bleeds
Need for ongoing skilled therapy to help determine readiness to wean strategies
History of slow or poor weight gain, inconsistent weights while in NICU especially as PO trials
increased, h/o > 7% weight loss or at risk to not regain birth weight by 10 days of life
Ongoing choking gagging, coughing, or spitting( w/weight loss, +/or concern for pain with spitting)
Arching with feedings, crying with feedings, turning away from nipple, or nasal reflux
Desaturations, decreased heart rate, or visible retractions with PO feedings breast +/or bottle
Difficulty organizing for a feeding, irritability with feedings, requiring re alerting to “get through” Po
Requires side lying position or pacing/regulation to manage flow rate of nipple
Requires increased supplemental O2 to support the work of feeding, with O2 support at home
Evidence of habituation or perseveration with nipple indicates sensory impairment
Decreased regulation of state, continuing to require waking at touch times vs. spontaneous
Infant requiring cereal thickened feedings
MBSS/OPMS or any other diagnostics such as upper airway assessment with abnormal finds
Feedings described as messy, concern for volume loss with feedings
Feedings taking longer than 30 minutes to complete
Concerns re: progression/skill maintenance once home or need closer follow up at DC
Difficulty transitioning or introducing bottle from breast