Transitional feeding guidelines to bolus feed

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Hello all Neonatal nures,I was checking online and I could not find any guideline for transitional feeding to bolus feed.

I read a lot of articles but most of them they don't have any guideline.

The one we have in our hospital is very complicated and makes the baby's feed every hour an a half which is not recommended for preterm and babies with feeding intolerance ..

In case you have any guidelines just share it ..

Thank you...:redbeathe:yeah:

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Specializes in NICU, ER.

In our facility we use very small continuous feeds until the baby reaches a target age and is moved to a bolus of a sm amount every 12 or 6 hours. And then dependant on many factors the pt is moved to a every 3 hour mark that is gradually increased to there target and the PICC line supporting the TPN and Lipids is removed. This is an in house feeding protocol. Hope this helps!

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But how to move to the bolus feed,what is the protocol ?

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Specializes in Neonatal ICU (Cardiothoracic).

We don't have a protocol. We generally try all babies at least initially on bolus feeds. If they aren't tolerated, we do continuous feeds, and/or then compress gradually over 2.5, 2, 1.5, 1hours.... over a few days as tolerated.

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We also start with bolus feeds and see how they tolerate it. It can also depend on the baby's attending on how they are fed goes too. No set protocol

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In our facility we use very small continuous feeds until the baby reaches a target age and is moved to a bolus of a sm amount every 12 or 6 hours. And then dependant on many factors the pt is moved to a every 3 hour mark that is gradually increased to there target and the PICC line supporting the TPN and Lipids is removed. This is an in house feeding protocol. Hope this helps!

Thank you

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Specializes in Neonatal ICU (Cardiothoracic).
In our facility we use very small continuous feeds until the baby reaches a target age and is moved to a bolus of a sm amount every 12 or 6 hours. And then dependant on many factors the pt is moved to a every 3 hour mark that is gradually increased to there target and the PICC line supporting the TPN and Lipids is removed. This is an in house feeding protocol. Hope this helps!

This is how my old unit did things... and it took FOREVER for kids to reach full feeds and get their lines out. Lots of central line infections and ROS'es in that place.

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Specializes in NICU.

It depends on weight. ANY baby, no exceptions, under 1500gm goes under the feeding protocol. 1ml q4 for 48hrs then q2...then gradual increases every 48hrs...it takes 7-12days to reach "full feeds". It's strict, but it works and our nec rates have gone down. And we push for colostrum and breast milk as much as possible!

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