clinical question for neonatal nurses

[Lisa252]

] I am trying to benchmark what other hospitals are doing with regards to initial breast milk feeds of elbw infants when mom does not have much milk yet. I would appreciate it if some of you wouldn't mind answering a few questions:

] Since the initial feeds will be very small amts, do you feed per gravity or put on a pump? If placed on a pump, how do you prime your tubing without wasting those precious amts of breast milk? Our tubing uses 1.7 just to prime and if mom is only getting 1cc of colostrum...well, you see the problem. I'd appreciate any feedback along with the hospital you work at. Thanks so much!

[rnkaytee]

We really try to wait until mom has colostrum to start any gut-priming feeds - we do a LOT of hand expression instead of pumping for better amounts. We don't put any of our feeds on a pump so we would just use an intermittent 5 Fr OGT (if less than 1000 grams) for feeds. We also do a lot of oral care with colostrum (basically just EBM on a swab in the mouth).

[NicuGal, MSN, RN]

We just push it thru the tube. We don't usually use a pump until it is over 6 mls as most kids tolerate a slow push or gravity up to that.

[karnicurnc, MSN, APRN, CNS]

We also feed small amounts by gravity, very slowly, over a few minutes. Larger volumes are pumped in over 30 mins unless there is feeding intolerance.

[neverthoughtnursin]

No matter what the amount, breast milk is only given by gravity