FIRST, “KNOW” HARM: Response to Letter to the Editor
This response is written on behalf of our colleague, friend, mentor, and lead author, Dr. Steven B. Leder, who unfortunately passed away in May of 2016.
The main focus of the letter “FIRST, DO NO HARM: A Response to ‘Oral Alimentation in Neonatal and Adult Populations Requiring High-Flow Oxygen via Nasal Cannula’” by Dodrill et al.  is the unsupported allegation that our article describes and advocates for a potentially harmful practice in the neonatal intensive care unit (NICU) population . In actuality, we propose that oral feedings can be successfully initiated in a select, pre-screened population that requires non-invasive respiratory support via high-flow nasal cannula (HFNC). Specifically, we believe that the most critical factor in minimizing risk in these infants was a thorough selection and exclusion process to assess readiness to feed. In infants who met these criteria, the presence of a HFNC in and of itself did not impede successful initiation of oral feeding .
KeywordsContinuous Positive Airway Pressure Neonatal Intensive Care Unit Oral Feeding Respiratory Inductance Plethysmography Instrumental Assessment
Compliance with Ethical Standard
Conflict of Interest
No conflict of interest.
- 8.Shetty S, Hunt K, Douthwaite A, Athanasiou M, Hickey A, Greenough A. High-flow nasal cannula oxygen and nasal continuous positive airway pressure and full oral feeding in infants with bronchopulmonary dysplasia. Arch Dis Child Fetal Neonatal Ed. 2016;101(5):F408–11. doi: 10.1136/archdischild-2015-309683.CrossRefPubMedGoogle Scholar