Have you ever not fed/hydrated an infant?

  1. The thread on the general nursing board has me curious. I have never seen this in our unit. If the baby is able to get off the vent and have a "life" as bad as it may be, we always attempt feeds and give IVF. Most of our kids like this end up NG or GT fed. We have had DNR kids go home with tube feeds, but we have never offered the option of just taking them home without anything. That poor little one most likely has enough brain left to go on ticking along for a while.

    Sigh...I really don't like those big full term kids like that
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  2. 14 Comments

  3. by   dawngloves
    So far I've only had patients that would pass as soon as we took them off the vent. We hydrated them up until then.
    The termers are the hardest.
  4. by   prmenrs
    We have sent babies to Hospice, where they are not fed or hydrated, they are given pain meds and held 24/7 until they pass. Parents and family often do most of the holding, but if they can't the hospice staff does it.
  5. by   KRVRN
    If a baby is no longer vented, and the decision is to withhold care, we also have sent babies to Hospice, where feedings and hydration are withheld.

    We did do this ourselves with one particular baby we had and she passed on our unit.
  6. by   nurseiam
    We had a baby in our unit that had HIV. When she was very sick the teen parents with the support of the gradparents wasnted to withdraw support. Since the baby had an unusually high viral load it was what was best for the baby. A week and a half passed before the family gathered to withdraw the vent support. The baby was actually much better by then and lingered for three awful days. I don't think they were feeding any longer. It was very tramatic for the staff because it was over a weekend it was the same nurses for the duration. In the end the family left the hospital and the baby had not yet died. It was very sad.
  7. by   magRN
    We have sent babies home with their families to die and they did not have any way to obtain fuids.

    I was interested to learn that many of you send familes to a hospice? Our unit is smaller and we care for families in this situation ourselves unless the family chooses to go home.
  8. by   MA Nurse
    Quote from NicuGal
    The thread on the general nursing board has me curious. I have never seen this in our unit. If the baby is able to get off the vent and have a "life" as bad as it may be, we always attempt feeds and give IVF. Most of our kids like this end up NG or GT fed. We have had DNR kids go home with tube feeds, but we have never offered the option of just taking them home without anything. That poor little one most likely has enough brain left to go on ticking along for a while.

    Sigh...I really don't like those big full term kids like that
    Yes, where I used to work, we with-held feedings on a baby as the parents wished...after talking to the MD's of course. We gave pain meds. I didn't like it...but you can keep babies alive for a long time if they are being fed when in a "vegetative" state.
    That's why I don't work in hospice.
    Sad.
  9. by   justme1972
    As a student who eventually wants to work in the NICU...Please tell me that it is standard procedure to send high doses of pain medication, in the event all nutrition is withheld
  10. by   SteveNNP
    I've never seen this done... if we are sending the baby home, (having survived extubation, and parents want care continued) babe goes home with a GT on full feeds.
  11. by   MA Nurse
    The baby I took care of was never on a vent. Some babies are anencephalic or have Trisomy 13, etc. and withholding nutrition is an option. Yes, usually pain meds are given, not in overdoses, just at the highest dose. I've only had apt. like this once or twice in 17 years.
    P.S. Sorry, i didn't realize this post was so old.
  12. by   RNSC
    Thanks Kimbalou for posting
    I just sent a baby home with hospice.It was one of the hardest things I've ever done. the baby went home with full G-tube feeds mainly because no one could tell the parents how long the baby would live or what the outcome would be. Even the genetist was not sure but wanted the baby and parents to be comfortable. The parents just wanted to take the baby home and live each day "as it came" and not worry too much about the future.
  13. by   TiffyRN
    We've had a couple of babies that had all support withdrawn with expectations they would pass quickly; and they didn't. It may have happened more than that but in those two cases the parents eventually left and went home and left the baby with us where we held the babes until they passed. One was a higher gestational age (maybe term) trisomy 18 that had been on tons of drips and HFOV for it's heart but it was alert and ok after all support withdrawn. We were allowed to nipple feed it but poor thing didn't have a clue what to do with the bottle. Thankfully it's heart issue caught up quickly.

    I don't understand leaving your dying baby in the hospital but I know this; I can't imagine the trauma and grief and I cannot pass judgement on someone going through something I hope to God never to experience. What I know is that those babes felt love and compassion from a fellow human being in their final moments.
  14. by   MA Nurse
    Quote from TiffyRN
    We've had a couple of babies that had all support withdrawn with expectations they would pass quickly; and they didn't. It may have happened more than that but in those two cases the parents eventually left and went home and left the baby with us where we held the babes until they passed. One was a higher gestational age (maybe term) trisomy 18 that had been on tons of drips and HFOV for it's heart but it was alert and ok after all support withdrawn. We were allowed to nipple feed it but poor thing didn't have a clue what to do with the bottle. Thankfully it's heart issue caught up quickly.

    I don't understand leaving your dying baby in the hospital but I know this; I can't imagine the trauma and grief and I cannot pass judgement on someone going through something I hope to God never to experience. What I know is that those babes felt love and compassion from a fellow human being in their final moments.

    I know what you mean...how can the parents leave? i've seen that, too. But everyone knows what they can handle. One time we had a family that was extremely grief stricken and kinda loud, so they went to a different hospital room until the baby passed away. It was very sad.

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