Syringe Feeding Near Term Infants

Specialties NICU

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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

When OI do extra duty in the nsy I refuse to cup/syringe feed. A few shifts ago I walked onto shift to find a 34-35 weeker (barely big enpough for nursery wt and had good lungs) and they were syringe feeding b/c nursery protocol says breast feeding babies dont get bottles. this kid had never sucked on anything bigger than a syringe for almost 2 days because of course she wasnt feeding well!! How is a 35 weeker going to learn to PO feed from a breast if he is learning form a syringe! Yes, I wne tin there taked to parents about my concerns of aspiration and not learning to suck and they said they were asking the same thing all day and the only answer they got was from the nsy/postpartum nurses was "we don want nipple confusion." SO, 2 sayd later (after she had some practice sucking on a bottle) she was breast feeding like a dream.

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Hey there :)

I work in a small hospital that has no NICU... but if the baby can eat and breathe, we keep them- otherwise, we ship them! I am an RN and a *gasp* LC. I pride myself on not being a nazi.

I find that fingerfeeding with a syringe is great when you have a very small amount of colostrum... say 5-8mls. I have had 4 lb babes that do well when feeding by this method. Putting it in a bottle seems like you lose half of your milk. Sometimes I have the mom just express her milk into a medicine cup then pop the top off of the syringe and pour it in- put my 5 fr. tube on and then when the baby sucks actively, I push in a titch with every 3rd suck or so.

I think Nipple confusion is pretty over rated... but in the case where a mother has HUGE nipples or super flat nipples- I believe its better to get the kid acclimated to what the mother has. In most of the population.. this isn't an issue.

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I work in both a level III NICU and NBN. Near term infants who are able to go to newborn nursery, may be syringe fed but only if a lactation consultant is involved. We prefer to use the supplemental nutrition system. Our system looks like upside down bottle that has a small tube connected to it. The tube is taped to the mothers breast and as the infant sucks, milk is pulled through the tube and into the babies mouth. It is our policy that any near term infant admitted to NICU will not be cup or syringe fed. They are either gavage fed, bottle fed, or remain on IV fluids until breast feeding is well established and mom's milk is in. We feel there is a greater risk for aspiration, oral aversion, emesis, and respiratory problems when cup or syringe feeding any infant.

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Specializes in NICU, PICU, educator.

I just had a mom that was insisting we cup feed her infant. No way...first, we are not allowed to do that due to the fact that a few years ago we had 2 kids from NBN that aspirated. Then she wants to syringe feed...that's fine and dandy if I have easy kids, but I have 3 kids and the other 2 are not easy kids (our census is skyhigh). This kid is on the launching pad to get out, I told her that she needs to be there to BF at least 4 times a day and the other we will give a bottle. Her response...I'm too busy, and I don't want a bottle. Well, guess what, I am willing to work with you, but you need your boobie at the bedside!

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Specializes in NICU, Post-partum.
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

We are very fortunate to have a wonderfully understanding LC at our facility.

Our policy is this:

1. We will not honor a request for no pacifier or no bottle...this is because speech therapy as well as the nurses, use pacifiers to assess willingness to eat and ability to hold a seal before nipple feeding is attempted. They are also used to encourage the idea of "full tummy when it's getting filled" during gavage feedings as well as comfort when the infant is NPO. We educate parents that sucking is NATURAL to an infant...and it brings comfort and soothes the baby...therefore, you are attempting to take away, what nature intended.

2. These babies are in a critical care unit, unlike well-baby, therefore nutrition is an optimum priority.

3. We will not do syringe or cup feeds due to the aspiration risk of this particular group, as most of these children are admitted for RDS....this was actually suggested by our LC and backed up by our Neo.

4. Keep in mind, I work in a Level III.

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Specializes in NICU, Post-partum.
Hey there :)

I work in a small hospital that has no NICU... but if the baby can eat and breathe, we keep them- otherwise, we ship them! I am an RN and a *gasp* LC. I pride myself on not being a nazi..

I would wager that you probably get more cooperation from your staff because of this :)

I am all for breast feeding...100% encourage it, 100% support it, I don't think our hospital does enough to encourage it.

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Our LC staff does suggest this to parents. And I have been asked to do this occassionally. That being said, this is not something that I EVER do. Like you, I have yet to see research that says this is safe/effective. Quite honestly, I worry about the possibility of aspiration, not to mention, we just don't have the time to do this (I know that sounds horrible, but it's true).

When parents ask me to do it, I tell them that they are welcome to syringe feed when they are on the unit, but it is not something that the nurses do. I've never had a parent get upset with me saying that, but if they did, I would tell them that we do not have a policy regarding syringe feeding, therefore, we are not able to do it (which is true).

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