Early enteral feeding for the very low birth weight infant: the development and impact of a research-based guideline.

Providing optimal nutrition for the very low birth weight (VLBW) infant is critical during the neonatal period. Evidence-based practice guidelines are essential in managing these fragile infants. Putting scientific research into daily clinical practice may be arduous at times, however. A multidisciplinary team of health care providers successfully established a practical feeding guideline for a 52-bed, teaching-affiliated, Level III neonatal intensive care unit in St. Louis. This guideline identifies human milk as the recommended source of nutrition for the VLBW infant, a suggestion that has significantly affected lactation services in the unit. This article describes the process of developing, implementing, and evaluating a feeding guideline based on current research and describes the impact on lactation rates of having such a guideline in place within the unit.