Feedings while on Indocin???

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Is anyone seeing neo's starting feeds on babies who are on Indocin? Supposedly there is "current research" showing good outcomes with doing this, but it's freaking all the nurses on my unit out thinking we are setting our babies up for a perf. Does anyone know of any research articles saying this is ok to do???

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Specializes in NICU.

I haven't heard anything like that. We don't use Indocin anymore, only NeoProfen.

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Specializes in NICU- now learning OR!.

If the RNs are really against this practice, yet the Neos insist on recent studies suggesting it is safe, can they provide a reference to educate the nursing staff?

We have a Nurse Educator for our unit who would be in charge of this.

Recently, there was a baby that the nursing staff was having trouble understanding the Neos decisions on care, so we asked about it (basically "Are we waiting for this baby to crap out before we do anything" - okay, so not the nicest way to ask!!)

One of the Neos took a looong time to explain in detail the problem, drawing pictures and everything. Explained the course of the problem and the anticipated clinical signs for us to watch for, and what they will do for treatment.

Boy, was I glad I asked! (although next time I will be a bit nicer!)

:p :p

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Specializes in NICU, Med/Surg.

We never stop feedings because of indocin.

And more important, I don´t think if I have ever seen a perforation thought to be related to indocin and food.

But then again, I think we give food earlier and more than you guys do in us. Today i took care of a 23 weeker with full feedings (440gram/3 days old)!

Sorry, but I don´t have any research articles......

Anna

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Today i took care of a 23 weeker with full feedings (440gram/3 days old)!

Seriously?!!!! wow don't tell our Neos we're already feeding earier than I'm comfortable with for some of the the babies.

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Specializes in NICU, PICU, educator.

We have had a few kids perf with Indocin therapy, but we are now using ibuprofin, so we will cont priming feeds.

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Specializes in NICU, ER/Trauma.

the thought process is, that yes, even with NeoProfen, but with lower incidence, that the reason why there is an increased incidence of NEC after Indocin/NeoProfen therapy is because the drugs provide a decreased perfusion to the gut. Therefore, the thinking in some circles is to hold feeds, JUST IN CASE.

It is important for nurses to remember that NeoProfen is a drug with LESS FREQUENT side effects than Indocin, it DOES still have the SAME side effects. They're not as common, but they still exist.

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Specializes in NICU.

I didn't mention anything about the side effects of NeoProfen, just that I couldn't really answer this question because we no longer use Indocin. But I will add that all of our babies are NPO while on NeoProfen.

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We do not feed while on Indocin. But some small kids that we give prophyllactic indocin to (23-24 weekers generally), usually are on fluids for the first few days of life anyway.

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Specializes in NICU.

Once in a while our docs will try to start or continue tropic feeds while on Indocin, but we usually ask them do D/C them because it makes us so nervous. Way too many spontaneous perfs on Indocin! However, we do see a lot of them on kids that are NPO and some that have never even eaten at all. Does the ibuprophen really come without the risk of perforation? I hope we get to use it soon, but for now we're still using Indocin.

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Specializes in NICU, ER/Trauma.
Does the ibuprophen really come without the risk of perforation?

NeoProfen comes with all of the same possible side effects as Indocin. The positive aspects of NeoProfen are that the side effects, while the same, occur less frequently. So, NeoProfen is not a miracle drug, but it is really really nice to use, knowing that those nasty NECs won't occur as often.

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we have has docs that continue feeds during indocin/neoprofen and those that make the child NPO. We've asked why, given that we are aware of decreased gut perfusion with both medications(or the potential for). The docs who conitinue feeds have explained that they too have research evidence stating that NEC is assosiated with not feeding early enough in the micropremies (which is contrary to what was thought just a few years ago, when we made all micropremies NPO because it was thought that feeding too soon would increase the risk of NEC!). The bottom line is that there is ongoing research on NEC, and it seems we are getting conflicting results. I feel this can be contributed to the fact that NEC still remains a mystery for the most part....we still aren't sure what the difinative cause is, and though we have narrowed down possible contributing factors and populations most at risk, we still don't know for sure. For instance, how about that 37weeker that comes to us from the well baby nursery, pale and green, diagnosed with NEC and perf?

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