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OG tube during feedings/cleft lip & palate kiddos

Specializes in L&D,Mother/Baby, WHNP,Educator,NICU.

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?


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

Specializes in NICU, PICU, PACU.

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

Specializes in CDI Supervisor; Formerly NICU.

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.


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