Feeds while on indocin

[NicuNightRN]

What do you think of continuing feeds while on indocin? We've had several kids that have perfed lately after being fed while on indocin. They were not tolerating feeds before indocin was started (trophic feeds) and then these feeds were continued. I know that it's impossible to pinpoint the exact cause of the perf, and we don't know if it would have happened without the indocin, but it always seems a little fishy to me when it happens during or right after a course of indocin. Thoughts, anyone?

[wjf00]

No feeds with a known PDA where I work. It is risky to add feeds to a hypoxic gut.

[dawngloves, BSN, RN]

I think we handle feedings different than most in usa do.....

All babies are started on breastmilk within their first 2-3 hours of life (unless surgery is expected ofcourse) and most of them have full feedings within their first week. That includes 22 weekers as well as fullterm babies.

We usually don´t stop feedings for any other reason than if we suspect nec (we have fewer cases of nec compared to usa, maybe because of our use of breastmilk?).

Preterm babies with severe symtoms of PDA are still on full feedings and sometimes that is the reason for chosing to try and close it.

Indocin isn´t used that often in our unit, but I don´t think I have seen any baby that developed nec.

Anna:p

But what are you feeding babies if you start trophics within 2-3 hours of birth? and is this also true for neonates that have had Mag Sulfate or Cocaine exposure? How about birth asphixia?

[fergus51]

I think we handle feedings different than most in usa do.....

All babies are started on breastmilk within their first 2-3 hours of life (unless surgery is expected ofcourse) and most of them have full feedings within their first week. That includes 22 weekers as well as fullterm babies.

We usually don´t stop feedings for any other reason than if we suspect nec (we have fewer cases of nec compared to usa, maybe because of our use of breastmilk?).

Preterm babies with severe symtoms of PDA are still on full feedings and sometimes that is the reason for chosing to try and close it.

Indocin isn´t used that often in our unit, but I don´t think I have seen any baby that developed nec.

Anna:p

Thanks for the reply. My hospital in Canada was similar. We fed most within 12 hours and most babies were up to full feeds within 2 weeks, but the hospitals I've worked at here in the US don't do that.

[lovemyjob]

I had a kid last night with TOF varient (on PGE, so he has a PDA) and he is on full feeds. kid is a preemie, 28 weeks I believe, (but about a month old)so he has some growing to TRY and do, but either way, we are feeding with a PDA. Any one else feed with other heart defects other than a standard PDA?

Sorry if this is a little mumble jumble, dont think too clear after working a PM

[elizabells, BSN, RN]

Okay, I clarified today - all kids on Indocin are NPO, and after the first dose someone from surgery comes and checks their belly before they get another.

[Sweden]

But what are you feeding babies if you start trophics within 2-3 hours of birth? and is this also true for neonates that have had Mag Sulfate or Cocaine exposure? How about birth asphixia?

They are given donated breastmilk until the mum produces her own milk. Sometimes fullterms are given other types of food (if we have a low supply of donated breastmilk) until mum produces enough. Almost all mums use breastpumps and expect to braestfeed when the baby is big enough or feels better.

Exposure to cocaine and other dugs are extremely rare and I can´t say I remember how we handle those babies.

We feed babies with birth aspixia just as all others and I haven´t seen anything gone wrong yet....

Anna

:typing