Feeding practices in public hospitals' neonatal intensive care units: An exploration into the ways in which COVID-19 affected the best practice in Gauteng.
Kim A Coutts, Joanne Neille, Nicole Louw
PMID 35924606WHAT IT FOUND
In two South African NICUs, lockdowns left staff overloaded, so nurses took over feeding, mothers were often absent, and caregiver training stopped.
Key findings
01Overcrowding and staff shortages made the three-hourly feeding routine difficult, with one site 16% overcapacity and each nurse responsible for up to 10-15 babies per mealtime.
02Lockdown restrictions shifted feeding to nurses and interrupted caregiver training, because mothers were often unavailable and training for parents and nurses stopped.
03Only 22% of healthcare workers agreed that babies should start breastfeeding before discharge, while 40% of observed infants were fed non-orally.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study looked at only two public tertiary NICUs in Gauteng, so it may not reflect other hospitals or private settings. Mothers were excluded, so the findings do not report how families themselves experienced feeding restrictions. The paper uses structured observations and interviews to describe practices, not patient outcomes, so it cannot show whether feeding methods caused harm or benefit. Data collection lasted 12 days at one site and 5 days at the other, which may limit how much of normal NICU variation it captures. The observation and interview tools were self-developed, although a pilot study was done and no changes were needed.
The easy way to misread this
Do not conclude that COVID-19 alone caused the feeding problems. The paper says overcrowding, understaffing and limited resources existed before the pandemic and were amplified by it.