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That is a very developmentally appropriate practice. Infants who are on long term gavage feeds will lose the association between sucking and their tummy becoming full. This complicates things when you actually start to attempt po feeds. I always also dip my paci in MBM d5 or the formula to give them a little taste.
and as far as your "feeding specialist" goes ummmmm I think she better find another title.
I am very surprised that a Level IV referral center isn't doing this. It has been a known benefit for a long time. I always offer a pacifier during gavage feedings. Now the AAP is recommending pacifiers to help prevent SIDS for all babies. I think pacifiers are especially beneficial for preemies!!
Yes, you were right...they should be doing it. And with parents that don't want a pacifer..we tell them why we are doing it, esp with a kid that is going to not nipple for a long time.
Your feeding specialist sounds like she needs to go to a few conferences...our OT people go all the time.
So okay. During my preceptorship on the NICU, I came up with the brilliant idea (I thought) of giving the babies on gavage feeds a paci to help them associate sucking with full tummy goodness. I mentioned this to one of the nurses and she looked at me like I was a moron and said she didn't think the babes would make that connection. Our feeding specialist said "yeah, I guess, I never thought of that..." Now, this is a level IV regional referral center. So I figure I'm just being silly, although I did keep doing it, except the one baby whose parents were ADAMANT she never use a pacifier. Just now I noticed that the illustrious Gompers put forth this idea in another thread here. So what do you all think? I don't think I was giving the babes too much credit developmentally.
We've done that a lot on my unit, unless the mom is against pacifiers.
It is easier to also cut a hole in the end of the paci and put the OG tube through the hole, if you know what I mean. It's easier to use one with the hole, IMO.
We do the same thing, it's nipple training. Does the mom who refuses pacifiers want to breastfeed? How is her babe going to learn to nipple all it's feeds? Premies don't go straight to breast from tube feeds.
Well, some do. Some units will only tube feed, then breastfeed. There are moms who absolutely refuse any artificial nipples.
I've always done this. Sometimes the babe won't take the paci and that's OK. It's too early for them. You could encourage mom to have the baby suck on her finger while the baby gavages.
FWIW, I have a friend that breast fed exclusively her kids for 2 years each and they were also binky addicts, so it's not a given that babies with pacifiers won't take to the breast.
elizabells, BSN, RN
2,094 Posts
So okay. During my preceptorship on the NICU, I came up with the brilliant idea (I thought) of giving the babies on gavage feeds a paci to help them associate sucking with full tummy goodness. I mentioned this to one of the nurses and she looked at me like I was a moron and said she didn't think the babes would make that connection. Our feeding specialist said "yeah, I guess, I never thought of that..." Now, this is a level IV regional referral center. So I figure I'm just being silly, although I did keep doing it, except the one baby whose parents were ADAMANT she never use a pacifier. Just now I noticed that the illustrious Gompers put forth this idea in another thread here. So what do you all think? I don't think I was giving the babes too much credit developmentally.