Yet ANOTHER question for you...

[VickyRN]

When do you use orogastric tubes on babies and when do you use nasogastric? What are the differences? I know neonates are obligate nose breathers and so orogastric is preferred at first. When do you start using nasogastric or do you ONLY use orogastric in the NICU?

[CatRN]

Dear Kristi,

8Fr tubes are usually only for decompression in my experience, and also used for feedings and decompression for babies on NCPAP. I have used 8Fr's on kids who are large >3kg, or if the baby happened to be on rice cereal, which some NICU's still use for reflux which makes for a heck of a fun gavage feeding by gravity!! I prefer 5fr's or 6fr's for indwelling NGT's.....unless of course the kid is huge and an older baby. Ever since how quick a feeding goes in by gravity with an 8fr? What baby can drink that fast, let alone who's belly can be literally "dumped" with a feed that quick? Again, nursing preference unless ordered. Those are just my personal preferences, there are of course exceptions :)

[nicudaynurse]

In my unit >1800 grams may have an 8fr. and

We use silastic feeding tubes that can stay in for 30 days. The babies that don't have a silastic have their feeding tube changed every other day.

I find it so interesting how all the NICU's vary in their practice.

Have any of you ever heard of high frequency CPAP? Well we have done it on our unit. We also do SIMV/CPAP (definitely an RT nightmare), but it seems to work on some of the babies.

[prmenrs, RN]

We use the silastic 5fr indwelling tubes, feedings went in via pump over however long we wanted it to--sometimes over 2 hours if they were bad refluxers.

It seems like for most places there is a right way, a wrong way, and the way we do it HERE!

I have not heard of high frequency CPAP, but have been out of Level III for a while (retired). Nasal SIMV/CPAP has been around for a bit, I think they got a new device that's not so hard on their noses.