Preemie Nipples - page 3

My unit will not send a baby home until they can use a term nipple, but I see preemie nipples for sale all over? What are your guidelines? Do you send babies home using preemie nipples?... Read More

  1. by   Mimi2RN
    Fergus, if the bili is really high, we do start IV's on those babies. Our docs also order formula feeding, with a bottle. The moms can't stay on our unit, and it's hard for them to come in for every feeding, if they have been discharged home. Also, the bili level goes down faster when they are formula fed. We do transfer them to peds when possible, so parents can stay. It will take longer to get the level down, because the baby will be out from under the lights a lot more, when mom is there.

    Sorry, I think the thread got hijacked.
  2. by   fergus51
    No worries, we do start IVs on kids with crazy bilis, but not just to avoid formula is what I meant. And once they are under the lights they don't come out for more than 20 minutes every 4-6 hours, less if they are really high. A kid under triple ain't comin' out.
  3. by   dawngloves
    We wrap our kiddos in a Wallaby when they come out to breast feed.
  4. by   fergus51
    Sigh... we have none here. I miss them.... I am sure the parents would love them, but until the bili is safe, the kid has to stay under our lights, naked and yelling.
  5. by   Mimi2RN
    Fergus....naked babies? Do you keep them in a crib or isolette? Most of ours are in cribs, it would be dangerous to have term boy children naked
    Pretermers are in isolettes, so that wouldn't be a problem.We do have those cute little pampers that fit the little ones like peri pads.
  6. by   fergus51
    We keep them in isolettes when they are under the lights (term or preterm), and we are supposed to have the maximum amount of skin exposed which means naked (especially for kids under triple). Some of us do make "baby g-strings" out of masks.
  7. by   NICU_RNwantsFL
    Our unit recently had an overhaul regarding preemie nipples - we dumped them, based on the theory that if an infant can't accommodate a term nipple, he's not ready to PO feed yet.
  8. by   nekhismom
    We have CURRENT 25 and 26 weekers PO feeding at least qd! It's INSANE!!! And I do feel like screaming EAT! EAAAAATTT! at some of the older kids. But, alas, I'm just an RN, and I have no say-so at my facility. *that's why I'm moving*
  9. by   nekhismom
    We don't do cup or finger feeding, but nearly all of our kids have an NG tube. Some of them don't get feeds through it anymore, but it remains in for the "convenience" of the nurses. The docs and NNP's only allow a few kids to actually nurse at the breast, and usually only once a day. Those who take breast milk take it from a bottle. Period. So far, we haven't had any parents refuse to allow kids to take the bottle. So far.
  10. by   Gompers
    Quote from nekhismom
    We have CURRENT 25 and 26 weekers PO feeding at least qd! It's INSANE!!! And I do feel like screaming EAT! EAAAAATTT! at some of the older kids. But, alas, I'm just an RN, and I have no say-so at my facility. *that's why I'm moving*

    OMG I just cannot believe this! Most of our 25-26 weekers are on the vent, and even those who aren't aren't stable enough respiratory wise to PO feed. Plus, whatever happened to the fact that babies don't develop the suck-swallow-breathe reflex until 32 weeks?!?! This is just so wrong, and such a huge risk for aspiration pneumonia.

    I don't blame you for wanting to move! Good luck at your new place!!
  11. by   Gompers
    Quote from NICU_RNwantsFL
    Our unit recently had an overhaul regarding preemie nipples - we dumped them, based on the theory that if an infant can't accommodate a term nipple, he's not ready to PO feed yet.
    In some ways I agree with this, in some ways I don't.

    We've had some extremely IUGR babies who are 2 pounds but 36 weeks gestation, PO ad lib, on high calorie formula, using preemie sized nipples (back when we had them), gaining weight and doing fine. Their mouths are just too small for the term nipple, but they are otherwise mature enough to PO feed.

    Then we'll have some kids who are fine with the size of term nipples, but they need the slow-flow ones labeled premature, and with these they do absolutely fine PO feeding and are usually switched to regular flow before discharge.

    I guess that I feel this way because we've had so many kids not PO feed during that 32-40 week gestational period, and then when you try and PO feed them later they are totally averted and it's like we've missed the window to teach them to eat. So if we can use a preemie sized nipple or a slow-flow one, why not?

    But I do understand what you're saying, for the most part it's true. There are just cases here and there where excpetions could be made.
  12. by   BittyBabyGrower
    Dawn...I had to laugh...sometimes I feel like taking the top off the bottle,dumping it on the cloth and saying...there, we're done now :chuckle

    We rarely use the preemie nipples...we may start some kids on them, but they don't stay on them long. Our OT department doesn't like them...they don't help them build up the muscles in the cheeks, etc.

    We don't cup feed at all, we will on occasion finger feed, but I agree...how is a finger like a nipple? Duh :uhoh21:

    We have had moms that want an IV in there kids too...and some of them were NURSES! Our attendings will not bow to them. Hello, why poke a kid a zillion times, then he gets staph epi sepsis and is there even longer? Geez. Also, we will not NG a full term BF kid. We tell them moms that they can BF while they are there, we will finger feed or bottle feed. We usually have the moms do a fingerfeed too, or the dads so that they can see that sometimes the kids don't do as well.

    I think as a parent, I would do what I had to do to get my baby home!
    Last edit by BittyBabyGrower on Mar 14, '04
  13. by   nekhismom
    Quote from Gompers
    OMG I just cannot believe this! Most of our 25-26 weekers are on the vent, and even those who aren't aren't stable enough respiratory wise to PO feed. Plus, whatever happened to the fact that babies don't develop the suck-swallow-breathe reflex until 32 weeks?!?! This is just so wrong, and such a huge risk for aspiration pneumonia.

    I don't blame you for wanting to move! Good luck at your new place!!
    In response to the lack of suck-swallow-breathe....we're told to just "pace" the kids. Just like we would pace older PO feeders. You know,tilt the nipple down or take the bottle out of the kids mouth to "cue" them to breathe. It's scary. We have several 26-26 wkrs on vents, but many of them are not. It's weird.
    I don't feel comfortable PO feeding one that small. It's always preceeded by a prayer on my part.

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