Transition from NG tube feeds to all PO

AmandaFaith

I'm just wondering what sort of protocol your NICU is using (or used) to transition your LOs from tube feedings to all breast/bottle. Long story short, after having it pulled on Thursday, my DD's NG had to be replaced today because she is repeatedly refusing to wake up for all of her feeds and is losing weight. I expressed my concern when the tube was initially pulled that I thought all PO feeds were too strenuous for her just yet (she just started them on Mother's Day...) but my concerns were pretty much shrugged off by the NNP working that day. Come to find out, that NNP was not following protocol when she decided to pull the tube in the first place.... Grrrrr!!! In order to have her tube pulled for real, DD must be taking 75% of her daily fluids by mouth, consistently, for at least several days. Obviously it varies from child to child, but how long did it take your LO to be able to handle all PO feeds once they initially started eating by mouth? (DD is 15w5d actual/5 days corrected.)

Allibob

We're not totally there yet, but my LO needs to be taking 75% as well. I'm not sure how many days they require before pulling the NG though. They'll then monitor his total daily intake instead of focusing on a certain number of mLs per feed. If he takes 75% of his daily goal for a few days, then he can go home.

My son is 9w1d actual/39w1d corrected. He started PO feeds at 33w4d, and just this week started taking 70% here & there.

It does seem fast for them to pull the NG tube if she just started on Mother's Day, but I guess it clicks for some kids faster than others. I had secretly hoped to have my son home by now, but he's just not strong enough yet.

ziggy903

I think it was about 2 weeks from trying bottles to getting the NG out.
He was getting close to being able to pull the NG when he pulled it himself. Feisty little guy. The nurses decided to wait and just put it in if he needs it, and he didn't need it.

aforst

We introduced a bottle for the first time on May 10th. She still had her tube in at that point. She did ok, but not great for the next week. Last weekend I requested that they let her take a break from the bottles on Saturday and Sunday. We weren't really getting anywhere and she was just getting exhausted.

I got them to agree to pull her tube this past Monday to see how she would do. She did pretty well and still gained weight so they extended it. Her tube is still out and she's on a 2-4 hour ad lib schedule. Her volumes have been good and she's still gaining. We also have had trouble with her staying awake for her feeds. She's falls asleep and forgets what she's doing and drops her heart rate.

My main point is that we tried the bottles and she clearly wasn't ready. We gave her a break and she's doing really well. If you don't feel like your LO is ready, I ask for the tube to be out back in. GL!

ETA: she was born 33+5 and is 39+4 today)

ashleymarie512

Our NICU wouldn't remove NG until she took 100% PO for 48hrs. Once OT gave the go ahead to try to do all PO, she didn't look back and that was the start of her 48hrs and she came home the day after she completed the 48hrs. She was born at 29+6 and came home at five days before her EDD.

Funny story--when her 48hrs were up, the nurse went in to remove her tube and she had already pulled it out herself She knew she was a rock star!