Gastric lavage in healthy term newborn??

Specialties Ob/Gyn

Published

At the hospital I work at as an L&D nurse, approximately 75% or more of our newborns are lavaged at least once. As a new nurse I am uncomfortable with this practice and feel that it is unnecessary. I spoke with one of my trusted professors from the University of Minnesota and she stated that this is an OLD PRACTICE that is not recommended. I have only been able to find 1-2 research articles on the topic and they both support what my professor is saying.

What are other hospitals doing?

The nurses that I work with who believe in newborn gastric lavage claim that....

1. It should be used if a newborn is not nursing well. It empties the amniotic fluid out of their stomach so that they are hungry.

2. It should be used if a baby is "gaggy" so they nurse better and so that they don't spit up the mucous and choke on it.

I feel that lavage is performed too frequently at my place of work and I would like to change or eliminate our policy that allows this. I need some more information to help clarify this issue before I attempt to move forward with this change. Please help!

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Many years ago I worked w/newborns, both healthy and in ICU, and I never heard of gastric lavage for any of them!!! Maybe if there was meconium, but I cannot remember ever performing this on healthy infants.

Just the idea of it makes me want to gag! YUCK.

Where is the info on this???? YUCK, again.

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Specializes in Maternal - Child Health.

I started in the NICU in 1986 and worked in various aspects of OB/NICU thru 1998.

This must be VERY old school, because I never saw it routinely done.

The one and only order I ever had for gastric lavage in a newborn was a near term infant who was delivered of a mom who was horribly ill with chorioamnionitis. The fluid was pus filled, odorous and thick.

We lavaged the infant in an effort to remove as much contaminated material as possible in the hopes of minimizing the baby's risk of infection.

As a routine measure, this is way off base. Too much potential for trauma and electrolyte imbalances.

A baby coming from a sterile environment does not need it's tummy washed out. If there's too much gunk in the baby's stomach, s/he will vomit it up and be all better.

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Specializes in MCH,NICU,NNsy,Educ,Village Nursing.

Look at standards of newborn care. Use of standards is often a good way to successfully argue your case, especially in a situation of "we've always done it this way". You might also Google "best practices.....".

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I have never heard of such a thing. Wow, talk about "old school"!

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Specializes in pediatrics, public health.

Here's a study that showed no advantage to gastric lavage in healthy newborns:

http://www.ncbi.nlm.nih.gov/pubmed/16324616

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Specializes in NICU, PICU, PACU.

We did that over 25 years ago but not anymore! We have one fellow from another country that wants us to do that all the time and we refuse, there is no good reason to do it. And the amniotic fluid is supposed to be in the stomach when they are born...I never heard that rationale ever!

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Eeekkk...tack that onto just another reason why I gave birth to my son at a birth center, with the help of a CNM. Sorry for the snarky remark...I couldn't help myself :p Kudos to you researching this. Good luck working to get this practice changed at you hospital.

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
The nurses that I work with who believe in newborn gastric lavage claim that....

1. It should be used if a newborn is not nursing well. It empties the amniotic fluid out of their stomach so that they are hungry.

2. It should be used if a baby is "gaggy" so they nurse better and so that they don't spit up the mucous and choke on it.

I feel that lavage is performed too frequently at my place of work and I would like to change or eliminate our policy that allows this. I need some more information to help clarify this issue before I attempt to move forward with this change. Please help!

Well, I do agree with that somewhat, but the times where I really felt it was the case is few and far between. I think I've only lavaged a baby twice. These were babies who were EXTREMELY gaggy, and EXTREMELY fussy, and had a lot of bloody mucous (leftover blood from delivery).

And YAY, U of M! I went to school there! :yeah:

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Specializes in Community, OB, Nursery.

I've seen it and done it, but maybe twice, and it's been several years since the last time. Definitely not the norm, and I'd be worried if it were.

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Specializes in Professional Development Specialist.

Maybe you did your OB clinicals at the same hospital as me? I observed this and thought it was an awful thing to do to a newborn. Even the nurse who performed it hated doing it but did it for the same reasons listed. I decided 1-I am not cut out to be an OB or mom/baby nurse and 2- I would never give birth at that hospital even though it is across the street from my house.

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Specializes in NICU.

I used to work at a facility where they routinely deep suctioned all newborns in the delivery room to clean out their bellies, but not of lavage as routine care of a term newborn. I have to admit, there were less feeding issues at the old place I worked for than at the place I work for now, where they do not deep suction newborns in the delivery room.

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