feeding and tachypnea

[asher315]

How fast a resp rate is too fast to po feed? Recently had a doc go ballistic because the nurse "defied" the order to remove NG tube and po feed despite the infant with rr 70-100"s. Anybody have any input? Won't tell you what our director said about the situation, makes me angry just to think about it! Thanks!

[babybums]

Will not attempt to nipple feed with respiratory rate over 60.

[NicuGal, MSN, RN]

How old was the baby? We have had some older chronics or kids that were MAS that are baseline high resps, we will go up to 70 with those kids. Otherwise it is over 60, tube feed, over 80 hold feed. We have this this written in our routine protocol.

[asher315]

Newborn was 2 days and had an NG and PIV running. Don't know what the doc was thinking.

[NicuGal, MSN, RN]

That's why we put it in our protocol...then we show it to them. Sometimes the docs just don't get it.

[prmenrs, RN]

I would not po feed a 2 day old baby, either preterm or term, w/a RR of >70. Why is the RR high? What does the X-ray show? CBC/CRP?

From you post, it looks like the doc wanted to pull the NG and po feed? Is that correct? If so, why, in the face of the increased RR?

[TiffyRN, BSN, PhD]

I've known chronic kids that could safely PO with incredibly high respiratory rates. I would not be the one PO feeding a 2 day old with RR 70-100. I know 60 is the acceptable RR for safe PO feeding but around these parts, most docs will tolerate up to 70/min even in a fresh newborn, but not higher and not with any signs of increased WOB.