Infant-Led Incubator Weaning: A Promising Paradigm Shift in Preterm Neonatal Care.

Abstract

Background: Thermoregulation is paramount in preterm infant care, traditionally addressed through nurse-led incubator weaning protocols. Recent research has introduced infant-driven incubator protocols that are demonstrating promise.

Purpose: This study, conducted at a freestanding academic pediatric hospital in the mid-Atlantic, examined the impact of infant-led incubator weaning on a specific neonatal cohort. The primary hypothesis posited that infants in the infant-led weaning group would wean out of the incubator at earlier gestational ages and lower weights, while maintaining comparable or greater weight gain during the transition to open cribs.

Methods: A retrospective chart review compared 40 infants weighing less than 1500 g before and after a weaning protocol change.

Results: Infant-led weaning demonstrated lower weights at weaning to crib ( M = 1836.80 g) compared with nurse-led weaning ( M = 1975.9 g), with statistical significance ( t [36] = 2.27, P =  .02, Cohen's d = 0.74). Infants in the infant-led group had a lower weight change 5 days prior to weaning ( M =  141 g) compared with the nurse-led group ( M =  185 g), which is also statistically significant ( t [36] = 1.93, P =  .03, Cohen's d = 0.63). T-tests revealed no significant differences in gestational age at wean to crib, change in weight post-weaning, gestational age, or days to discharge.

Implications for practice and research: Infant-led weaning emerges as a safe alternative with potential benefits for preterm neonates and their families. While initial positive outcomes are evident, further research with a larger neonatal cohort is imperative to validate the efficacy of infant-led weaning as a successful alternative to traditional methods.