by magRN

Recently we changed our feeding protocol: After babys have advanced on hourly feeds to volume (IV"s d/c'd) we go to every 2 hour volumes....and then advance the oral feeds staying on Q2hr, where before we'd advance to Q3hr volumes before attempting oral feeds....adjusting for cal/fluids and wt gain on the brst fed babes.

This new protocol is very time consumming...and seems to have it's share of frustations to nurses and famillies. We didn't have a problem really before either.

What do you all do in your NICU's...I'd be interested in knowing. We had a very high success rate before with regard to sending babes home on all brst feeding also. With the new schedule it seems it isn't as good although the numbers are still out. Seems the frustations over-come the families more with this new change.

Thanks....guess I'm more than alittle frustrated myself.

When we start feedings, we always try Q3hr feeds first. We titrate down the IV as the baby reaches full feeds, whether NG or PO. We only do continuous feedings if the baby is having feeding intolerance. We never do Q2hr feedings. We might start a micropreemie on Q6hr trophic feeds of colostrum, then move to Q3hr feedings.

We start the preemies on 2 hourly OG/NG feeds, titrating the feeds up and the IV down. Then when they are up to full feeds we go to 3 hourly. Usually by this time they are ready for breast or bottle, whichever is the mother's choice.

On tiny ones, we start cont. feeds, then go to q2's and then when they are about 1200-1300 grams we go to q3's. If they are tolerating feeds, we go up by 10% a day and decrease the IV.

Our's are continuous with an IV+PO, then transition to q3 gavage. For reflux we run it in over 45-60 min. When the baby is ready for oral feed we cup feed the breastfeeding. We also trophic feed all micropreemies as soon as the UAC is out. Usually 1-3cc q3. Every 2 seems crappy! We hate it when we have a minimal handle on q3 trophics.

Seems like you all do what we did...and it worked fine! Thanks for sharing!