I'm just curious how your units handle volume parameters for feedings? Is there a policy your neos follow or do they all "make their own rules"?
I recently had a term baby (39 weeks) who came to us for rule-out sepsis due to lethargy and hypothermia. He had normal temperatures for us in an open crib and wasn't the most active baby in the world, but would wake for feedings and cry vigorously until he was tended to. His blood cultures were negative after 48 hours and antibiotics were d/c'd. He was ad lib feeding from the beginning taking around 30 mL per feed every 2-3 hours, occasionally up to 40 and 50 mLs (mostly formula, mom was supplying minimal amounts of breastmilk). At four days of life he was still eating the same. He also had adequate urine output and was stooling regularly 2-3x/day.
In my experience this is an appropriate feeding amount and schedule for a term neonate who is only a few days old. The neo who saw him for discharge seemed to think he should be eating 60 mL every feeding and lasting 3-4 hours between feeds.
What's the difference between eating 60 mL q4h and 30 mL q2h? I worked in a labor and delivery/postpartum unit previously and we only expected 1-2 day old term neonates to eat 15-45 mL every 2-3 hours.
Sometimes I feel like the NICU world doesn't remember how to treat term babies when it comes to feeding!!
Thanks for your input.
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I'm just curious how your units handle volume parameters for feedings? Is there a policy your neos follow or do they all "make their own rules"?
I recently had a term baby (39 weeks) who came to us for rule-out sepsis due to lethargy and hypothermia. He had normal temperatures for us in an open crib and wasn't the most active baby in the world, but would wake for feedings and cry vigorously until he was tended to. His blood cultures were negative after 48 hours and antibiotics were d/c'd. He was ad lib feeding from the beginning taking around 30 mL per feed every 2-3 hours, occasionally up to 40 and 50 mLs (mostly formula, mom was supplying minimal amounts of breastmilk). At four days of life he was still eating the same. He also had adequate urine output and was stooling regularly 2-3x/day.
In my experience this is an appropriate feeding amount and schedule for a term neonate who is only a few days old. The neo who saw him for discharge seemed to think he should be eating 60 mL every feeding and lasting 3-4 hours between feeds.
What's the difference between eating 60 mL q4h and 30 mL q2h? I worked in a labor and delivery/postpartum unit previously and we only expected 1-2 day old term neonates to eat 15-45 mL every 2-3 hours.
Sometimes I feel like the NICU world doesn't remember how to treat term babies when it comes to feeding!!
Thanks for your input.