127: Building Relationships in the Neonatal Intensive Care Unit with Rebecca Brown, M.S.,CCC-SLP, CNT
So you want to work in the neonatal intensive care unit? You may be surprised to know that it is not just sunshine and rainbows. Given the interdisciplinary nature of the NICU, the speech-language pathologist must navigate differing opinions on infant feeding through rapport building, establishing respect, and demonstrating the highest levels of professional competency.
Topics covered:
NICU and infant feeding competency baselines
Defining neuroprotection, family centered care, and the Dynamic systems model.
History of volume driven culture vs. Infant-Driven Feeding.
The interdisciplinary nature of feeding in the NICU.
Navigating different opinions through respect, rapport building, and demonstrating increased competency.
the Discussion Guide
Download your free Discussion Guide to unpack the information covered in the episode at a deeper level. The Discussion Guide can be used in a group setting or on your own.
the literature
Craig, J. W., & Smith, C. R. (2020). Risk-adjusted/neuroprotective care services in the NICU: the elemental role of the neonatal therapist (OT, PT, SLP). Journal of Perinatology, 40(4), 549–559. https://doi.org/10.1038/s41372-020-0597-1
Madlinger-Lewis, L., Reynolds, L., Zarem, C., Crapnell, T., Inder, T., & Pineda, R. (2014). The Effects of Alternative Positioning on Preterm Infants in the Neonatal Intensive Care Unit: A Randomized Clinical Trial. Research in Developmental Disabilities, 35(2), 490–497. https://doi.org/10.1016/j.ridd.2013.11.019
Nightlinger, K. (2011). Developmentally Supportive Care in the Neonatal Intensive Care Unit: An Occupational Therapist’s Role. Neonatal Network, 30(4), 243–248. https://doi.org/10.1891/0730-0832.30.4.243
Shaker, C. S. (2013). Cue-Based Feeding in the NICU: Using the Infant’s Communication as a Guide. Neonatal Network, 32(6), 404–408. https://doi.org/10.1891/0730-0832.32.6.404
Shaker, C. S. (2017). Infant-Guided, Co-Regulated Feeding in the Neonatal Intensive Care Unit. Part I: Theoretical Underpinnings for Neuroprotection and Safety. Seminars in Speech and Language, 38(2), 96–105. https://doi.org/10.1055/s-0037-1599107
Shaker, C.S., (2018). Reading the Feeding. The ASHA Leader. https://doi.org/10.1044/leader.FTR1.18022013.42
Van McCrary, S., Green, H. C., Combs, A., Mintzer, J. P., & Quirk, J. G. (2014). A delicate subject: The impact of cultural factors on neonatal and perinatal decision making. Journal of Neonatal-Perinatal Medicine, 7(1), 1–12. https://doi.org/10.3233/NPM-1476313
Waitzman, K. A. (2007). The Importance of Positioning the Near-term Infant for Sleep, Play, and Development. Newborn and Infant Nursing Reviews, 7(2), 76–81. https://doi.org/10.1053/j.nainr.2007.05.004
Wellington, A., & Perlman, J. M. (2015). Infant-driven feeding in premature infants: a quality improvement project. Archives of Disease in Childhood. Fetal and Neonatal Edition, 100(6), F495-500. https://doi.org/10.1136/archdischild-2015-308296
Resources:
National Association of Neonatal Therapists: https://neonataltherapists.com/
Feeding Matters: https://www.feedingmatters.org/
Neonatal Therapy Certification Board: https://neonataltherapycertification.com/
Certified Lactation Counselor: https://centerforbreastfeeding.org/lactation-counselor-training-course/clc-certification/
Thanks for these amazing resources, Rebecca!
Rebecca Brown is the lead inpatient speech-language pathologist at CHRISTUS Good Shepherd Medical Center. Rebecca is responsible for staffing, the development of policies and procedures, and training in the acute care setting. She is a certified neonatal therapist and the primary speech-language pathologist in a level III NICU. Rebecca is pursuing her Ph.D. in Health Sciences with a Neurologic Rehabilitation Concentration at Rocky Mountain University of Health Professions. She adjuncts at two local universities. Coursework includes anatomy and physiology of the speech and hearing mechanism, speech science, and neuroanatomy and physiology. Rebecca serves on various committees at the local, state, and national level. Her passion is the evaluation and treatment of dysphagia across the lifespan.
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