feeding problems

[carla.hca]

Any advice?

I work as a HCA on a neonatal ward. We have a set of twin girls who were born at 28+2. They are now 94 days old. The only thing keeping them both on the unit at the moment is the fact that we cant establish feeds with them! They were being breast fed but are now bottles. The problem is they will only take half their required amount on a good feed. After a few minutes they simply decide they no longer want it and will either go back to sleep or become upset! Every possible teat has been tried with no obvious results to the point that they have probably been confused! Each feed is taaking about an hour, feeding, waking them up, and feeding again. It's really quite bizaar, both girls are just the same and no one seems to know why!!! Anyone got any tips on how to get these babies to feed? They even demand their feed every four hours but then they just dont want it and they are now loosing weight. I want to help the parents to get their beautiful girls home but it seems their getting nowhere!!!!

[UTVOL3]

I would not get too worried unless they passed the 40 week mark and were still being difficult. Sometimes they are just not ready.

[twinkletoes53]

Hi there,

The team have now changed their milk to a higher calorie formula in the hope that they will gain weight. They are 3 hourly feeds on a standard teat. As for it taking an hour, that's feeding each baby, waking again when they fall asleep and changing their nappy again in the hope that they will have another !!!!! So in all it takes about an hour atrt to finish!!!!!!!!!!

Nighmare, I tell you........poor little mites, it's such a shame!

We limit our po feeding atempts to 25-30 minutes maximum with each baby; otherwise they use more calories than they consume. I have had success with holding the infant upright, and after seeing OT use the technique with success, I've now started to rock the babies gently as they feed. It seems to get them into the "rhythm" of things. I also use chin and cheek support with the babies. It makes a tremendous difference in how well the baby feeds.

If you are taking a full hour to do each baby, start to finish, then they are exhausted and not getting enough rest. Speak to your MD about reinserting their nasogastric tubes, and try with alternating PO/NGT feeds, to give them time to sleep. You may even have to go to a schedule like "PO every third feeding" for a while, until they are stronger.

We have sent infants home with feeding tubes, if inadequate bottle feeding is their only issue. They often do much better with feeds at home, where they are in a quiet, loving environment with their parents. We have home health nurses visit on a regular schedule to monitor the infant's weights. Even if the infants corrected gestational age is close to term, I tell the parents to be patient, since the first few weeks of their baby's life was spent in such a high-stress environment. Also, are you co-bedding the babies? We co-bed all our multiples as soon as we can.