Feeding readiness and caregiver preparedness in neonatal discharge decision-making: Perspectives from a resource-constrained setting

Background Discharge readiness for preterm infants is usually based on weight gain and medical stability, while feeding and swallowing readiness are inconsistently assessed. In resource-constrained settings, discharge planning is further affected by staffing limitations, variable procedures, and limited caregiver preparation. Aim To explore healthcare professionals’ experiences of discharge decision-making for preterm infants, with particular emphasis on how feeding and swallowing readiness and caregiver preparedness are considered within the discharge process. Methods A qualitative study was conducted with 14 healthcare professionals (10 nurses, 4 neonatologists) purposively selected from a public hospital. Data was collected through semi-structured interviews and analysed using thematic analysis. Results Discharge decisions were guided mainly by biomedical criteria and resource pressures. Feeding and swallowing readiness was assessed informally through observation, with limited structured tools. Responsibility for feeding assessment was shared, while final discharge authority remained with the medical team. Caregiver preparation was often opportunistic and time dependent. Conclusion Discharge readiness is shaped by resource-constrained clinical environments in which professional roles are differentiated, while feeding and swallowing readiness and caregiver preparedness are inconsistently integrated into decision-making.