An investigation of factors affecting reciprocity between nurses and premature infants during bottle feeding

Every year thousands of infants remain in intermediate care nurseries for several months due to their premature birth. During this time, the majority of their needs are met by nurses instead of their parents. If, because of burnout, a heavy patient assignment, lack of knowledge, or other factors these nurses do not perceive and respond appropriately to behavioral cues sent by the infant, serious consequences may result. During the early months of life, infants communicate with their caretakers through various behaviors. When the infants' behavioral cues are not responded to in a timely, appropriate manner, they may develop a sense of mistrust resulting in infants who are irritable, difficult to feed, and who stop attempting communication with their caretakers.

The purpose of this study was to determine factors related to nurses' ability to perceive and act on cues given by premature infants. Factors considered as possibly affecting reciprocity were the number of infants the nurse was caring for, nurses' educational level, nurses' feeding experience, and nurses' parental status. The study design was descriptive correlational. Data was collected in an intermediate care nursery at a large urban general hospital. The sample consisted of all registered nurses, licensed practical nurses, and newborn technicians currently employed in the intermediate care nursery. After informed consent was obtained from each nurse, she was observed during two feedings sessions. The Modified Assessment of Infant-Maternal Emphathy was used to measure nurse-infant reciprocity.

The only factor found in this study to affect the perception and response of nurses to premature infants during bottle feeding was the number of infants assigned to the nurse. As the number of infants to be cared for increased, perception and response to behavioral cues decreased.