Traditional open-bay versus single-family room neonatal intensive care unit: a comparison of selected nutrition outcomes

Background: In contrast to the traditional open-bay–type design of the neonatal intensive care unit (tNICU), infants in developmentally appropriate NICU (dNICU) are housed in individual rooms with greater control of light and noise. Previous reports have documented positive influence of the dNICU in cardiorespiratory status, physiologic stability, and weight gain of the infants. The objective of this study was to explore selected nutrition outcomes of infants in the dNICU versus tNICU. Method: A prospective cohort study was conducted on infants with birth weight of 1500 g or less cared for in dNICU (n = 42) or tNICU (n = 31). Differences between days to reach full parenteral nutrition, full enteral nutrition, or full bottling were determined using analysis of covariance controlling for gestational age, birth weight, and clinical risk index for babies (CRIB) acuity score. Results: There were no differences between the two groups in days to reach full parenteral and bottle feeding. The infants in the dNICU took fewer days to reach full enteral nutrition (20.8 days, 95% confidence intervals [CI]: 17, 24.6 (dNICU) vs 23.3 days, 95% CI: 17.1, 29.6 (tNICU), P = 0.04) than those in the tNICU. Conclusions: Although the two groups of infants only differed in the days to reach full enteral feeding, it is important to remember that the lack of difference may be clinically significant. Clinically, the infants in the dNICU were younger (gestational age) and sicker (CRIB acuity score) than the infants in the tNICU. Consequently, the results of this study support the change to dNICU, as the private room model provides a supportive environment for growth as evidenced by similar nutritional outcome measures. More research is needed to determine the effect of the dNICU on nutrition outcomes.