q3hr bolus OG/NG feedings

Specialties NICU

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  1. When feeding bolus OG/NG feedings, does your unit policy say:

    • 29
      feed by gravity while staying near patient
    • 5
      manually push the feeding at 1-2 ml/minute
    • 9
      either gravity or manual push at nurses discretion

31 members have participated

When you have babies receiving bolus feedings through OG or NG tubes (and I'm not talking about little one or two ml trophic feedings or feedings given on pumps), does your unit's policy say for you to:

(1) feed by gravity while staying with the baby to observe for any problems

(2) manually push feedings through the syringe at a rate of 1 to 2 ml per minute

(3) feed either by gravity or manually pushing is up to the individual nurses discretion.

Tiki here...

I thought that passage in the book was interesting too (re: burping a baby after an ng/og feeding). All I can assume is it would be done for a baby who was being ng/og fed in someone's arms and would be done as a way of getting them used to the physical feeling of having their back patted... like a developmental care anticipatory guidence thing maybe. That's my best thought...

My previous hospital would put feedings on syringe pumps if they needed to be fed over 30-45 minutes (like for reflux babies) or if they were on continuous feedings. We would do the gravity feedings since they usually go in over about 20 minutes which is about the same amount of time a baby should spend nippling before he/she gets tired of sucking and gets the message to his brain that his/her stomach feels full.

My new hospital doesn't use the pumps because they think that if a baby would aspirate and the nurse wasn't watching carefully enough, that the formula could potentially continue infusing into the trachea. I personally like the thought of using a pump and standing at the bedside watching the baby; seems like I could watch the baby, do a little charting maybe, and be sure the food is being infused gently.

Thanks again to everyone for their responses!

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We use NG tubes taped to the face with tegaderm and replace them prn or at 30 days. Our feedings are run over 30 minutes with a syringe pump unless the volume is very small, then we will use gravity. Our policy states to place on syringe pump and set to infuse over desired time.

I would prefer that they were more specific with the time allowed for the feedings. Most articles I have read suggest 15-30 as a bolus feeding time.

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Specializes in NICU.

About the whole burping with the NG thing, this was the original quote from Tiki_Torch's post:

Administer feedings by gravity over 15-30 minutes; gravity allows for a natural 'burp' through the tube and avoids direct, forceful pressure into the GI tract.

The book didn't mean to pick up the baby and traditionaly burp, but rather to leave the tube open to gravity so the baby has an air outlet. I know that this happens to us frequently - larger babies or babies with bad reflux often "burp" up their tubes during NG feedings. If we were pushing the feeds in by hand or through a pump, they wouldn't be able to do this against the pressure and might have some emesis instead. We hang almost all our NG feeds to gravity, but don't usually stand there and watch it go down. Sometimes we have to give it another push if the baby has had one of those NG burps I mentioned. In 6 years, I've never seen a baby aspirate from one of these feeds, even if he pulled the tube out during the gravity feed. Just my experience! (BTW, we also use those silastic tubes and leave in place for 30 days. Usually NG, even with a nasal cannula so long as it's a low flow and not a higher-flow CPAP type setup.)

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I use a syringe pump for 5 fr. NG tubes and gravity feed with 6.5 fr. and 8 fr. NG tubes. I find the 5 fr. NG tubes take over 30 mins by gravity with bolus feeds of 20 cc's or more. We use the nutricath NG tubes which the manufacturer says are good for 30 days.

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Although our guidelines say gravity...we are changing to on a pump over 30 to 60 minutes unless otherwise ordered by the Neonatologist/Resident

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Specializes in Newborn ICU, Trauma ICU, Burn ICU, Peds.

Years ago when I first worked with neonates we gravity fed formula and put all breastmilk on syringe pumps secondary to the high fat content remaining on the walls of the gravity set. Now that I have returned to the NICU ALL babies that are fed via a tube are fed by either syringe pump (smaller volumes or breast milk) or a kangaroo pump (formula). Rate is really at the RN's discretion. Usually 20 mins to an hour depending on the baby. Also, we never (intentionally) sit at the bedside while a feeding is going in to observe the baby. You can't see if the tube coils up into the back of the throat during a feeding anyway. All of our patients are on monitors as well. Vinyl feeding tubes are changed q72hrs and silastics (corpaks) are changed q 30days, if they last that long...

Faith

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At our hospital we use a 3.5 fr neotube which is very soft, flexible, and tiny. We run our feedings over 30 - 40 minutes with a medfusion pump. Our neotubes are secured by placing duoderm on to the cheek, then taping the tube to the duoderm with the pink Hy-tape. We change our tubes every 5 days, and for the most part, they stay in place for the five days. This method works well for us, and we have not seen any aspiration problems from tube feeding this way.

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Our OG/NGT's are good for 30 days. If they come out, we simply wipe them off and re-insert. GROSS!!

FOr feeds, we can let it go by gravity or put the feeding on a pump over 30-60 mins. We DO NOT manually push feeds.

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