NG feed via syringe pump question

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Hi all, I'm currently in the NICU and have been using the electronic syringe pumps for NG feeds for the first time (the previous hospital I was at used gravity). Basically, I've been informed from another nurse that an additional 2 mL is added to the actual amount of feed to take into account the extension tubing. So for example, if a patient was to receive 20 mL of feed, I would draw up 22 mL but program the syringe pump for 20 mL. This basically results in 2 mL of feed being left in the extension tubing after the feed, which is discarded. Is this to be expected? Is the additional 2 mL that is added to the feed essentially to prevent air from going into the patient? I am just wondering, because if the extension tubing is primed (2 mL), why not just program the pump for 18 mL to prevent wasting of the feed? I feel like I'm missing something.

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Specializes in NICU.
This basically results in 2 mL of feed being left in the extension tubing after the feed, which is discarded. Is this to be expected? Is the additional 2 mL that is added to the feed essentially to prevent air from going into the patient? I am just wondering, because if the extension tubing is primed (2 mL), why not just program the pump for 18 mL to prevent wasting of the feed? I feel like I'm missing something.

You will have 2 mL in the tubing when the feed is done.

Unlike a gravity feed, the formula in the tubing remains in the tubing instead of emptying into the baby. If you program the pump for 18 mL, the baby is only getting 18 mL. If you didn't prime the syringe, the baby would get 2 mL of air and 18 mL of formula. By priming the tubing, the baby gets the whole 20 mL of formula. I am not sure why you are concerned with wasting 2mL of feed in the tubing.

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Specializes in Home Health (PDN), Camp Nursing.

Right but if you want the baby to get 20ml then you prime the tubing AND program for 20ml, than you have 2 ml left in the tubing when the feed is done. Amount infused 20ml. Amount used 22ml

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2 ml will be left in the tubing when the infusion is complete. But another nurse beat me to it LOL.

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You will have 2 mL in the tubing when the feed is done.

Unlike a gravity feed, the formula in the tubing remains in the tubing instead of emptying into the baby. If you program the pump for 18 mL, the baby is only getting 18 mL. If you didn't prime the syringe, the baby would get 2 mL of air and 18 mL of formula. By priming the tubing, the baby gets the whole 20 mL of formula. I am not sure why you are concerned with wasting 2mL of feed in the tubing.

Oh I see, that makes sense. My concern was because the mother doesn't express much milk and is against formula.

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Specializes in NICU.
Oh I see, that makes sense. My concern was because the mother doesn't express much milk and is against formula.

That can be an issue, but what happens tomorrow when the doctors order 22mL Q 3hrs. If she can't produce more than what the baby needs (increasing each day), then she needs to consent to formula or the baby will lose weight.

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That can be an issue, but what happens tomorrow when the doctors order 22mL Q 3hrs. If she can't produce more than what the baby needs (increasing each day), then she needs to consent to formula or the baby will lose weight.

Yes, I'll discuss this with her next time.

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Specializes in Pediatric Critical Care.

I hate to discourage a mom who is trying to feed their baby with breastmilk. :( Have you gotten a lactation consult for her? Does she need a few days for her milk to come in?

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I hate to discourage a mom who is trying to feed their baby with breastmilk. :( Have you gotten a lactation consult for her? Does she need a few days for her milk to come in?

Yep I called an LC to help with expressing, etc. and it seems like more milk is starting to come in! So all is good :)

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