Background. To promote optimal growth and development, developmentally appropriate neonatal intensive care units (NICUs) offer an environment that attempts to mimic the womb by controlling temperature, noise, and overstimulation.

Objective. To determine differences in days to reach feeding goals between traditional (tNICU) and developmentally appropriate (dNICU) NICUs.

Methods. A prospective cohort study was conducted on infants with birth weights of 1500 grams or less cared for in Sanford Children’s Hospital’s tNICU from November 28, 2005 to May 28, 2006 (n=25) and from November 28, 2006 to May 28, 2007 (n=29) after the move to a dNICU. Differences between days to reach full parenteral nutrition (FPN), full enteral nutrition (FEN), or full nippling (FN) were determined using Student’s t test, P≤0.05.

Results. There were no differences in birth weight [1063 g (955,1170) vs. 1036 g (932,1139)], gestational age at birth [28 weeks (27,30) vs. 27 weeks (26,28)] or days to reach FPN [4 days (3,5) vs. 5 days (4,7)], FEN [21 days (16,26) vs. 19 days (15,22)], and FN [49 days (37,60) vs. 59 days (48,71)] between the dNICU and tNICU respectively, [mean, (95% CI)]. Weight at FN was greater for dNICU [2457 g (2241,2673)] than tNICU infants [2156 g, (1956,2356)], P=0.04.

Conclusions. Infants in the dNICU were at a greater weight when they reached FN which suggests, that once infant weights stabilize after birth, the dNICU environment may be more supportive of energy conservation, thus greater weight gain, by allowing for more sleep and quiet-rest time than the tNICU environment.