Volume parameters for feedings

[FlutterbyNurse]

I'm just curious how your units handle volume parameters for feedings? Is there a policy your neos follow or do they all "make their own rules"?

I recently had a term baby (39 weeks) who came to us for rule-out sepsis due to lethargy and hypothermia. He had normal temperatures for us in an open crib and wasn't the most active baby in the world, but would wake for feedings and cry vigorously until he was tended to. His blood cultures were negative after 48 hours and antibiotics were d/c'd. He was ad lib feeding from the beginning taking around 30 mL per feed every 2-3 hours, occasionally up to 40 and 50 mLs (mostly formula, mom was supplying minimal amounts of breastmilk). At four days of life he was still eating the same. He also had adequate urine output and was stooling regularly 2-3x/day.

In my experience this is an appropriate feeding amount and schedule for a term neonate who is only a few days old. The neo who saw him for discharge seemed to think he should be eating 60 mL every feeding and lasting 3-4 hours between feeds.

What's the difference between eating 60 mL q4h and 30 mL q2h? I worked in a labor and delivery/postpartum unit previously and we only expected 1-2 day old term neonates to eat 15-45 mL every 2-3 hours.

Sometimes I feel like the NICU world doesn't remember how to treat term babies when it comes to feeding!!

Thanks for your input.

[ittybabyRN, RN]

I can't give you any parameters exactly but I did take care of a full term baby with an omphalocele repair, was po feeding a few days later, kind of slow to start, as soon as he would reach goal they would increase it...he was taking 120 cc q3 by the time he was discharged! which seems a lot to me, granted he did weigh 12 lbs but still!

[rn4lyfe08]

I have 1yr pedi RN exoerience. To me its all the same, though I more commonly see the infants under 1 month tend to eat 30-60ml every 2-3 hrs and 60-120 ml every 3-4 hrs. It really just depends on the infant. Som docs want then to take in 60ml q2, and some 120ml q4. As long as I'm averaging upwards of 60ml q2 I am happy. Less than 30ml Q2 would concern me, especially if it were a larger infant. Hope this helps.

[Elvish, BSN, DNP, RN, NP]

Our pedis don't get too worked up about it, as long as weight and output are appropriate. Some kids just seem to have different feeding patterns than others.