Procedure on NG/OG Tube Feeds

[NICU Mama]

I'm just wondering what other NICU's policies are. Where I work now, all of our ng/og feeds are given on a pump unless the volume is less than 5 cc's, in which case we hold the syringe and let it go in by gravity. I'm hearing that we are going to be changing how we do these feeds soon and will be doing more by gravity. The thought is that by putting the feeds in with a syringe pump, it is causing reflux. I'm not opposed to gravity feeds, I've done it at other places all the time. I'm hearing, though, that now when we hang a feeding by gravity, we will have to stand there and hold the syringe up with our hand and wait until it goes in. I won't mind when the volume is small, but I don't want to stand there for 30 min. or so when the volume is 50-60cc's. There is concern that if the syringe is taped up on the isolette (giraffe), someone could lift the top and pull the ng/og out accidentally. It seems to me that the syringe could be taped up outside the isolette so this wouldn't happen.

What do you all do?

[Imafloat, BSN, RN]

We do both pump and bolus feeds. Our little ones may start on continuous feeds, which then get consolidated to a feed over 2 hours every 3 hours, then it will switch to feed over an hour every 3. The next step is bolus feeds, which are all gravity. It usually doesn't take that long to give a bolus feed, even if it is 40 or 50 ccs, as long as the NG tube is big enough, those 5/6 french take forever, but the 8 french go pretty quick. We are not allowed to tape a feeding syringe anywhere, we have to hold it the entire time.

[littleneoRN]

We put all our feedings on a pump--we don't do anything by gravity. If it is small volume on a bigger kid--say initiating feeds on a new 32 weeker--and you're only giving 5 mL, sometimes we will hand-push that volume with the syringe. Then again, we use 3.5 fr NG tubes on all our kids--nothing bigger. So that would make gravity feeding a very tedious process.

[SteveNNP, MSN, NP]

Then again, we use 3.5 fr NG tubes on all our kids--nothing bigger. So that would make gravity feeding a very tedious process.

Wow..... 3.5s? I'm not surprised you have trouble with gravity feeds!!

The smallest I've used is a 5fr on a tiny one, and usually only continuous feeds.

Otherwise we use 6.5s or 8s and they run gravity just fine. Just secure the gravity syringe outside the isolette and keep an eye on it.

[elizabells, BSN, RN]

I like to put a looped rubber band on the attatched IV pole (on Giraffes, that have one) and hang the bolus syringe from that. Then you can add/subtract rubber bands to adjust your height and thus the rate of the feed. You can also tape a rubber band to the side of the isolette if you don't have an IV pole. For the wee ones that are only getting 0.5-3cc and thus have a 5Fr short tube, I sometimes hang them from the swing-arm inside the isolette - again with linked rubber bands.