OG tube during feedings/cleft lip & palate kiddos

Hi all,

I have a couple of quick questions. I was taught to take out an OG during nippling feedings with a bottle, but some of the staff are leaving them in (#5 Fr). I thought they can cause the baby to aspirate if left in. What is your unit's protocol?

Also, with cleft lip/palate kiddos, what bottle(s) do you use...Haberman, Cleft lip & palate (lamb), or other? Our speech therapist told us that Haberman's are the only one that should be used. What is your practice?

Thanks!

I wouldn't typically leave an OG in when PO feeding. If the kid needs supplemental tube feeds they should have an NG and that I would leave in...because if the baby doesn't finish their feed you can't drop a new tube right after feeding them, thats just asking for them to vomit and aspirate.

I have only ever seen our speech therapists bring up habermans for patients with clefts though depending on the severity some can eat from a regular nipple but usually we use habermans.

[NicuGal, MSN, RN]

You can leave them in....most kids don't really care and unless it is causing them to gag a lot, there really isn't a need to remove it. We have had them in for kids with choanal atresia and other cranio-facial things until they get a Gtube.

We use pigeon nipples or haberman's usually, it depends on the defect. We will mess around with various things until we figure out what works. Some, with a smaller defect, do okay with regular nipples, others have bigger or odd defects (I had one with a large defect on the right and then the rest of the palate resembled a sieve) who could only use the pigeon.

[Bortaz, MSN, RN]

We use Haberman nipples. Also, we don't remove the OGT each PO feeding. If the kid is going to consistently PO, but still need some gavage help, we place it NG. I am not a big fan of the in-out-in-out-in with the tubes.

We do not remove OG/NG tubes during PO feeds on my unit. I have heard of other hospitals doing it though. I guess some doctors feel that the tube can cause reflux or aspiration. Most of our kids who are nippling have NGs in, unless they have a nasal cannula, then they have to have an OG.

We have 2 different bottles used for cleft babies. We use the Haberman and the Mead-Johnson Cleft Palate Nurser.