OGT or NGT for neonates?

[Bortaz, MSN, RN]

Which is the standard in your NICU? Until recently, we pretty much always used OGTs on our babies, but lately the trend has been to use NGTs...haven't yet found anyone that can explain why we switched. A couple of explanations I've heard are:

Use of OGT causes problems when trying to teach the baby to nipple.

Use of NGT causes problems because neonates are obligate nose breathers.

So, anyway, which is the standard, and why?

Thanks!

[I'mANurse!]

We use NGT most of the time. Many times OGT are initially placed during resus to vent the stomach if any PPV is given and Babies on CPAP have OGT to continuously vent the stomach. Once feeds are begun or the baby is off CPAP, we usually transition over to an NGT. Part of this has to do with the actual tubes we use. Our NGT are 5 Fr, and our OGT are 8Fr. Also, our OGT are very short and are not compatible with our tubing for our syringe pumps, so hanging feeds is more of a hassle. I also prefer NGT for routine feeds because it's one less thing the baby has to have in the mouth to interfere with nippling or breastfeeding. Also, I've found that babies are able to more easily cough up their tube when its OG!

[prmenrs, RN]

I agree w/the above. imo, oral feeding tubes are way easier to dislodge.

[NJNICUCCRN]

We use oral tubes if it is a tiny baby on cpap that needs a real good seal with the prongs. Once the baby begins to gag on the OG tube, it needs to be switched to nasal

[ScammRNC]

We use OGT with infants that are intubated or on CPAP. Once they come off CPAP then we switch to NGT.

[SteveNNP, MSN, NP]

OGT when they are little, and are all-tube feeding, and need maximum NCPAP seal.

NGT once they are big enough to handle a tube in the nare, and start nippling. It's way too hard to try to get a preemie to seal around a nipple, let alone with an additional object in the mouth

[BabyLady, BSN, RN]

We use NGT's unless the baby is on oxygen, then an OGT.

OGT's are more subject to come out and need replacing because infant's work them out with their tongue and oral secretions can cause the tagederm or silk tape to come loose and that can be a big deal in the middle of a gavage feed if it works itsself half-way out.

[twinkletoes53]

Which is the standard in your NICU? Until recently, we pretty much always used OGTs on our babies, but lately the trend has been to use NGTs...haven't yet found anyone that can explain why we switched. A couple of explanations I've heard are:

Use of OGT causes problems when trying to teach the baby to nipple.

Use of NGT causes problems because neonates are obligate nose breathers.

So, anyway, which is the standard, and why?

Thanks!

We use OGTs in our unit when the babies are only tube feeding, or when they are intubated or on CPAP, even if they are NPO. Once we start bottle feeding, we get an order to change the tubes to NGTs. We use specific sizes based ion the infant's weight. If we pass an NGT and see that it's caused increased respiratory effort or distress for the baby, we'll talk to the doctor or APN, and have them write an order to switch the baby back to an OGT.