Nurses’ knowledge, attitudes and practices regarding feeding of low and very-low birth weight infants: a cross-sectional study at tertiary referral hospitals in Rwanda

INTRODUCTION: Enteral nutrition is an important part of neonatal care. To make enteral feeding as effective as possible, nurses must have sufficient knowledge, positive attitudes, and effective techniques. This study sought to assess the knowledge, attitudes, and practices of nurses regarding the nutrition of low and very-low birth weight infants (LBW and VLBW) in Rwanda. METHODS: The study took place in three tertiary referral hospitals in Rwanda from January to February 2020. A questionnaire was developed to facilitate the survey among neonatal nurses. Several items were used to evaluate their knowledge, attitudes, and practices concerning infant enteral feeding. Answers to knowledge questions were graded on their accuracy. Other items were rated on a Likert scale. RESULTS: There was a total of 47 respondents. The vast majority of them (83%) were female and aged 31 to 40 years. The average knowledge score for feeding LBW and VLBW infants was 65.9% (SD=24.3%). Nurses were excellent at understanding the benefits of breast milk, but there were discrepancies in caloric requirements for growth (21.3%), gastric residuals (38.3%), and feeding methods (8.5%). The vast majority of nurses had neutral or negative attitudes toward nasogastric tube (NGT) feeding. NGT feeding was a common practice, with 76.6% adhering to safety protocols and 74.5% assessing nutritional status regularly. Almost half of the nurses (48.9%) reported feeding delays due to workload. The majority emphasized early feeding and valued their role in neonatal care. CONCLUSION: In Rwandan tertiary referral hospitals, most nurses demonstrated adequate knowledge, neutral or negative attitudes, and relatively high levels of NGT infant feeding practices. Strategies are needed to improve and sustain this performance.