Do you give breastmilk/formula/glucose to vented patients?

Specialties NICU

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Specializes in NICU, Med/Surg.

I read a thread in the MICU/SICU forum about giving ice to intubated patients and started to wonder how other units handle this.

My unit encourages and allow us to give small amounts of food with each feeding (preferable with the pacifier). Glucose are allowed to all patients including the intubated or NPO patients.

Do you give breastmilk/formula/glucose to intubated patients?

Anna

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You mean PO? We've given glucose on a pacifier, but that's it. How would they swallow anything else?

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Specializes in midwifery, NICU.

We dont tend to feed babes on the vent. All nutrition via TPN, if the baby is that young and sick, then NEC would always be a worry.

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Specializes in NICU, Infection Control.

Depending on the NICU, some do "trophic" feedings starting @ ~ 12-24 hrs. Might be as little as 1/2 ml q 6hrs. We try to get colostrum for those feedings, but formula is ok. We would work up as tolerated to full feedings, preferably breast milk. NG tube is the method of feeding, pacifiers (non-nutritive sucking) are encouraged, and "Sweet-ease" can be used for comfort.

We also gave Trophamine and MVI the very first day in a separate infusion than the maintenance fluids. The feeling was that we needed to keep the baby on a positive nutritional footing.

I don't think we saw any increase in NEC w/these interventions.

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Specializes in midwifery, NICU.
We also gave Trophamine and MVI the very first day in a separate infusion than the maintenance fluids. The feeling was that we needed to keep the baby on a positive nutritional footing.

I don't think we saw any increase in NEC w/these interventions.

prmenrs, forgive me for asking, but across the continent here!And I'm no sure as to what Trophamine and MVI are. Maybe we give them already, and call them a different name?

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Specializes in Maternal - Child Health.
prmenrs, forgive me for asking, but across the continent here!And I'm no sure as to what Trophamine and MVI are. Maybe we give them already, and call them a different name?

Trophamine is the protein component of TPN, and MVI is a multivitamin in IV form. In the "olden" days, we used to maintain neonates on dextrose and electrolyte solutions for the first few days of life, then switched over to TPN and lipids. The rationale was based partly on difficulty in stabilizing their fluid and electrolyte balance in the first 2 or 3 days of life. It was easy and inexpensive to change their IVF, but deprived them of protein and nutrients crucial to healing and growth.

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Specializes in NICU, Infection Control.

If you give the Protein and vitamins in a separate infusion, you can change the glucose/electrolytes as needed w/o the expense (time and $$$) of having pharmacy make a whole new Hyperal. Lipids are started fairly early, too.

It's all about nutrition.

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Specializes in midwifery, NICU.

Here we still start on 10% Dex, and on second day either switch to TPN or 10%dex/0.18%NaCl , if it looks like the babe wont be needing fluids for very long.

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Specializes in NICU, Telephone Triage.

We only feed vented babies thru an NG or OG tube.

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We dont tend to feed babes on the vent. All nutrition via TPN, if the baby is that young and sick, then NEC would always be a worry.

You don't even give them food via OG or NG tubes? Do you get many long term intubated kids?

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Specializes in midwifery, NICU.

fergus, no, we try early weaning from the vent onto CPAP, and then start og/ng feeds. Am not saying this is right, just the way our unit does it. At times I am goin grrrrrr with the ultra conservative management, and vow to move to one of the bigger city hospitals where progression and research is key to practice. BUT....I love workin in our unit, and can see the potential to move things on a step or two.

One of these days..it wont be defensive practice ;)

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fergus, no, we try early weaning from the vent onto CPAP, and then start og/ng feeds. Am not saying this is right, just the way our unit does it. At times I am goin grrrrrr with the ultra conservative management, and vow to move to one of the bigger city hospitals where progression and research is key to practice. BUT....I love workin in our unit, and can see the potential to move things on a step or two.

One of these days..it wont be defensive practice ;)

It's just surprising to me because I've never worked on a unit that didn't feed intubated babies at all. But, the units I've worked on have almost always been big and had kids who were intubated for several weeks so they couldn't really wait until extubation. Do you stop feeding them if they wind up back on the vent after being weaned to CPAP (like if they get septic and need reintubation)?

Don't worry, I know what you mean about liking a unit even when you aren't crazy about all their practices... You don't want to get me started about respiratory management in my current place:)

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