Feeds while on indocin

Specialties NICU

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Specializes in NICU.

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?

I have worked in 3 different NICU's and non of them have ever fed babies while they were getting indo, regardless of whether they were getting fed before the med was started. I have seen babies perf though that were getting indocin and never fed at all so who knows.

I'm shocked to hear that any unit continues feeds while giving indocin! I have never heard of that and would never do it myself.

No wonder those kids perfed! We won't give it while the kid is #1 on Indocin #2 Still has a PDA.

Specializes in NICU, Med/Surg.

We never stop feedings when giving indocin unless the baby has other problems......

Anna

Specializes in NICU.

I had a baby c a large PDA and bad NEC who was charted as not a candidate for indocin - I will ask today if there was a connection (this all happened before I started in the unit).

Specializes in NICU.

We always hold feeds while a kid is on Indocin. If I remember correctly, I was told it was because Indocin can cause decreased bloodflow to the abdominal area, hence increasing the risk for NEC. If a kid has had their rounds of Indocin, still has a PDA and is going to have it ligated, we usually just wait until after the ligation to start feeds.

Specializes in NICU.

Yes, indocin does cause decreased blood flow to the gut, which is why I don't understand why so many of our docs continue feeds. The nurses always complain to the docs about continuing feeds. Apparently their reasoning is that having something in the gut will stimulate the bowel's blood flow. But I still think it's too risky to continue feeds...

We never stop feedings when giving indocin unless the baby has other problems......

Anna

That's interesting Anna. Do you have many babies perf while doing this? As you can tell, it isn't the norm in the US but I know a lot of countries do things very differently and it's interesting to hear about.

I've never fed a baby on indocin, though I've also never held feeds because of a PDA if it wasn't symptomatic like dawngloves

Specializes in NICU, PICU, educator.

We rarely use Indocin anymore....they seem to ligate them all now. But, we never fed kids on Indocin. I've seen a few kids perf after getting it.

I've never fed a baby on indocin, though I've also never held feeds because of a PDA if it wasn't symptomatic like dawngloves

I was kinda vauge. We won't start feeds after a course of Indocin until a PDA is confimed closed by ECHO, in case the baby will need to do another round.

Specializes in NICU, Med/Surg.
That's interesting Anna. Do you have many babies perf while doing this? As you can tell, it isn't the norm in the US but I know a lot of countries do things very differently and it's interesting to hear about.

I've never fed a baby on indocin, though I've also never held feeds because of a PDA if it wasn't symptomatic like dawngloves

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

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