Gravity Feeds

[NICU Mama]

I was just curious about how you all do gravity feeds. We usually tape ours to the inside or outside of the isolette. But if the baby is in a giraffe isolette, we use the "arm" so if the top is acidentally opened, it won't rip the ng tube out. But, at a staff meeting this week, our NM told us that we really should be holding all of our gravity feeds and not hanging them. I think it would be very difficult to stand there holding the feeding for 30 minutes while it goes in, especially when you are busy with three or four babies in your assignment. Anyway, I was just curious if any other units stand by their babies to hold the gravity feed while it goes in?

Thanks for your input.

[Mimi2RN, ASN, RN]

Over the last three years we've been told "Use syringe pumps", then "NO syringe pumps". Now the docs are ordering pumps and specifying a time. If they don't, some people use pumps and some don't. As long as they are aware of what is going on, I don't care! My only worry is having a baby across the room from a nurse who has no clue how the feeding is going.

A few years ago, we only had Bard pumps and all the feedings were held. Now we use Medfusion pumps for everything.

[RainDreamer, BSN, RN]

Syringe pump all the way! (for anything more than 5-10mL) Is there a reason why people don't use these or mostly just a lack of resources?

Some docs feel that putting the feed through via a pump is more forced .... and thus they prefer having the feed go in over gravity.

[MandaAnda]

I would like to hear perspective from those who do gravity feeds on how this time is managed with a 3-4 patient assignment. Thanks!

In my situation, there are normally other nurses around to deal with anything that comes up. Still, I've never had a feed take half an hour or longer. Ever. We do have pumps, and I guess if the doctors wanted it that slow, we'd put it on a pump. But it goes through 15min max in a gravity feed. We don't tend to use thickeners. All that goes down our gravity feeds would be any meds, EBM, formula and/or EBM with fortifier.

If I absolutely had to drop a gravity feed, I could click the plunger back into the syringe so milk wouldn't go everywhere and lay the syringe down (at the level of the baby, it would virtually stop flowing) and hit the emergency call bell if there wasn't another nurse within hearing distance of me.

[NicuGal, MSN, RN]

We do both. We don't have a specific protocal relating to this. Some kids do better with gravity...if they reflux, the feed tends to stop and then restart on it's own, and they don't seem to B as much, others like a longer feed. Each kid is different.