Evaluation of the Effectiveness of Chrononutrition Education Provided to Neonatal Nurses

BACKGROUND: Chrononutrition refers to aligning nutrient intake with biological rhythms, and human milk demonstrates natural circadian variation. In neonatal intensive care units (NICUs), infants often receive expressed milk, and mismatches between expression and feeding times may affect the development of infants' circadian rhythms. Nurses can play a critical role in maintaining this alignment through proper labeling, storage, and preparation. PURPOSE: This study purposed to evaluate the effectiveness of the "Chrononutritional Properties of Human Milk" training program on NICU nurses' adherence to time-appropriate expressed milk preparation. METHODS: This quasi-experimental study with a pretest-posttest design included 15 NICU nurses in Türkiye. Data were collected using a Descriptive Characteristics Form and a Chrononutrition Monitoring Form. The training consisted of 6 sessions (2 online and 4 face-to-face) delivered over a 5-month period. Following the intervention, nurses' milk preparation practices were observed for an additional 5 months. Descriptive statistics and Chi-square tests were used for analysis, with significance set at P < .05. RESULTS: Before the training, 1232 milk preparation procedures were observed, and 55.7% were chrononutritionally appropriate. After the training, 1240 procedures were recorded, and 66.5% were appropriate, representing a significant overall improvement (χ2 = 30.619; P = .001). Day-shift nurses demonstrated significant improvement (P = .001), whereas no significant change was observed during night shifts (P = .452). IMPLICATIONS FOR PRACTICE AND RESEARCH: The training improved adherence to chrononutrition-based milk preparation. Incorporating chrononutrition principles into routine NICU education may strengthen developmental care. Future studies with larger, multicenter samples are needed to confirm these results.