This study explored one woman's experience in becoming a mother to her premature son during his prolonged hospitalization. This paradigm case is an exemplar selected from a larger phenomenological study that examined the high-risk perinatal experience. Hermeneutic analysis led to the discovery of the phenomenon of maternal work embedded in the experience of this mother. Dimensions of her maternal work included working for love, working for meaningful moments, working amid uncertainty, working against the odds, and working overtime. Understanding the experience of maternal work can assist nurses to acknowledge and support the work inherent in becoming a mother within the neonatal intensive care unit.

Neonatal nurses often draw upon prior experiences and intuition to feed neonates. Such experience and skill vary from nurse to nurse and may not be based on recent research, nor tailored to each neonate's feeding skill. An evidence-based neonatal oral feeding guideline was produced to improve oral feeding practices among nurses and parents. The implementation was initially less than ideal, resulting in poor compliance. A bedside reference poster was designed to serve as a visual succinct reminder of the oral feeding guideline.

Gastroesophageal reflux and gastroesophageal reflux disease symptoms are common challenges for very low-birth-weight infants (<1500 g). These symptoms frequently result in feeding difficulties and family stress. Management of symptoms across healthcare disciplines may not be based on current evidence, and inconsistency can result in confusion for families and delayed interventions. The feeding relationship between infant and caregivers may be impaired when symptoms are persistent and poorly managed. An algorithm for managing gastroesophageal reflux-like symptoms in very low-birth-weight infants (from hospital discharge to 12 months corrected age) was developed through the formation of a multidisciplinary community of practice and critical appraisal of the literature. A case study demonstrates how the algorithm results in a consistent approach for identifying symptoms, applying appropriate management strategies, and facilitating appropriate timing of medical consultation. Application to managing gastroesophageal reflux symptoms in the neonatal intensive care unit will be briefly addressed.