Syringe Feeding Near Term Infants

Specialties NICU

Published

I have been asked by my colleagues to see how many NICUs and Newborn Nurseries are syringe feeding their near term or term infants. We have been having nursing mothers who have been discharged home but their infant remains hospitalized either in the NICU or Newborn Nursery and syringe feeding has been suggested by our Lactation staff. These mothers request that their infant have no pacifier or be fed by bottle. Instead they request their infant receive either EBM or formula only via syringe feeding. This can be very time consuming and at times frustrating when an infant does not like feeding via syringe.

Does anyone have good evidence based research that states this is a safe procedure, and any research that shows that it has a positive effect on near term or term newborns toward preventing a nipple confusion problem?

I would appreciate everyone's view on this idea and any opinions (positive or negative on syringe feeding) and any suggestions to help the staff toward having the infant be more receptive to syringe feeding.

PremieOne

Specializes in PICU, ICU, Transplant, Trauma, Surgical.

I have never seen a syringe feeding in our NICU. Babies that eat PO are bottle-fed and breast-fed is mom chooses. I will have to inquire about this whole syringe feeding deal.

Specializes in NICU, Infection Control.

If your unit doesn't do it now, and no one has brought the subject up, let sleeping dogs lie!!

The only reason I learned to do all these "alternative" feeding methods is to keep the lactation nurses happy. As it is, I think I've spent a goodly part of my professional life grabbing a perfect stranger's breast, and convincing her arching, screaming newborn to like it.

Specializes in Looking for a career in NICU.
If your unit doesn't do it now, and no one has brought the subject up, let sleeping dogs lie!!

The only reason I learned to do all these "alternative" feeding methods is to keep the lactation nurses happy. As it is, I think I've spent a goodly part of my professional life grabbing a perfect stranger's breast, and convincing her arching, screaming newborn to like it.

YOU ALWAYS HAVE THE BEST DESCRIPTIONS!

Specializes in midwifery, NICU.
If your unit doesn't do it now, and no one has brought the subject up, let sleeping dogs lie!!

The only reason I learned to do all these "alternative" feeding methods is to keep the lactation nurses happy. As it is, I think I've spent a goodly part of my professional life grabbing a perfect stranger's breast, and convincing her arching, screaming newborn to like it.

:lol2: Totally agree prmenrs, lactation nurses have been known to be a wee bit OTT! Can't apply the same farce to premies, (I am soo glad!) Also spent what seems like yEARS, with my back bent and my hand manipulating a boob for the wee darling to get on! I KNOW this is such a big No-No, hands off boob etc, but sometimes, one wee guidance of direction and they're away! Feeding like a dream! I will be flung off the baby friendly thingy now for my opinions!:lol2:

I am a postpartum nurse/lactation educator, I plan on getting my lactation consultant later, mainly for job advancement, variety of opportunities, etc. I breastfed my kids for ages, one past two. However, I am so DONE with the supplemental feedings we do at our hospital. I do fingeer feedings (with syringe) and tube-at-breast (supplemental feedings via syringe/tub in corner of baby's mouth at the breast) and it's a huge pain. Parents 90% of the time get way too dependent on the syringe/tube and before you know it they're giving the baby 40mL via the syringe. Why not just give the bottle? I understand the baby is at the breast in the latter case so there's no "nipple confusion" but finger feeding is completely useless, the finger is the same shape as a bottle nipple or pacifier, they may as well be sucking on that instead.

I always just breastfed mine and bottlefed occasionally when I couldn't take it anymore (too sore) or had to be away and none of mine had a problem. One of mine preferred me and took to refusing the bottle but would take it if she was hungry enough so it always worked out.

I would prefer if we did away with supplemental feedings entirely except if they are given by bottle. I don't think the other ways are helpful, at least in my experience.

I have been asked by my colleagues to see how many NICUs and Newborn Nurseries are syringe feeding their near term or term infants. We have been having nursing mothers who have been discharged home but their infant remains hospitalized either in the NICU or Newborn Nursery and syringe feeding has been suggested by our Lactation staff. These mothers request that their infant have no pacifier or be fed by bottle. Instead they request their infant receive either EBM or formula only via syringe feeding. This can be very time consuming and at times frustrating when an infant does not like feeding via syringe.

Does anyone have good evidence based research that states this is a safe procedure, and any research that shows that it has a positive effect on near term or term newborns toward preventing a nipple confusion problem?

I would appreciate everyone's view on this idea and any opinions (positive or negative on syringe feeding) and any suggestions to help the staff toward having the infant be more receptive to syringe feeding.

PremieOne

Specializes in Nurse Scientist-Research.

To mstigerlily;

Oh dear lord, can you please hurry and get certified and then clone yourself and take over all the LC's jobs across the nation? We could use some level headed non-zealot types in the the LC dept. Thankfully they don't get too overly insistent in the NICU.

Specializes in NICU,PICU.

no way. first, with syringe feeding...it seems that most comes out the other side...so why? and with finger feeding, unless you are using a sterile glove, who knows who's dirty hand has been in that box and what was on it. yuck. we don't do any of these in our nicu or in our well child. we were getting kids from wcn that were blue and a few had aspirated, so the docs put a stop to that.

To mstigerlily;

Oh dear lord, can you please hurry and get certified and then clone yourself and take over all the LC's jobs across the nation? We could use some level headed non-zealot types in the the LC dept. Thankfully they don't get too overly insistent in the NICU.

Oh I wish I could. I don't mind doing lactation as part of my job but unfortunately, I think 12 hrs of dealing with nothing but breasts would do me in. I think you have to be a zealot to want to do that for 8-12 hours every day, day in and day out!

Specializes in NICU, CVICU.

If we were to have to start all these "alternate" feeding styles for each different kid, we'd have to double our staff! Who has time to do all that?

If mom wants to exclusively breastfeed, then she needs to have her breast at the bedside at feeding time...otherwise the kid gets a bottle...plain and simple.

Specializes in Retired NICU.

i've certainly seen the various alternatives to giving a bottle. fortunately, these are not an "issue" where i currently work. i really don't think the "nipple confusion" issue is a problem for most kids. i do support use of a nipple shield as a transition between breast and bottle for premies. the attitude of no bottle, no formula, no pacifier really frosts me...had a 2-day old admitted to nicu the other day (term) with a blood sugar of 20, that was exclusively breastfeeding! i realize that colostrum is generally adequate for most term infants until breastfeeding is established, but there are exceptions for sure. fortunately, haven't seen any babies that have aspirated due to alternate fdg methods; have seen babies admitted in critical condition from starvation due to prolonged, unreasonable "breastfeeding" (electrolytes all screwed up, very dehydrated, etc.) i realize this is not the norm, and i do support breastfeeding. however, i agree with this:

if mom wants to exclusively breastfeed, then she needs to have her breast at the bedside at feeding time...otherwise the kid gets a bottle...plain and simple.

Specializes in NICU.

Nipple confusion usually seems to be on the part of the mother! The babies aren't confused at all. Now some babies certainly do better on the breast than bottle fed, but they don't starve.

My youngest was hospitalized a few days after delivery, was bottle fed at that time, which was miserable for me. He never took a bottle after that, acted like he was being poisoned! He was weaned to a sippy cup a few months later.

We don't cup feed or syringe feed, any mom that insists on breast only has to come in for all feedings.

Specializes in Community, OB, Nursery.

I'm a well-baby nursery nurse. Our policy right now is that no breast babies get bottles unless peds ordered or mom requests. If a BF mom wants the babe in the NBN, we will cup feed x1 and then baby goes back out to mom for the next feed. If mom is BFing but says baby can get a bottle the kid can stay in all night. I think that's a little discriminatory but the powers that be (2 of whom are LCs) wrote the policy.

I personally have cupped a lot of babies & never had any problems c aspiration. That said, I think it's a little silly as I don't believe in nipple confusion. About 90% of our Hispanic mothers breast and bottle their babies and everyone does just fine. My own son BFed for 15mo, got a binky from day 2 and never had a problem.

We call our most radical LCs nipple nazis.

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