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Transition from tube feeding to oral feeding

jesbethjesbeth member
in Preemies

If your LO required an NG (nasal gastro) for tube feeding, what advice were you given to help your LO graduate to oral feeding 100% of the time? And how quickly did this happen?

DDs feeding schedule was every 3 hours, alternating between a bottle and NG feed (I am EPing due to DD being unable to latch) and we were going to watch for cues if during the 6 hour stretch between bottle feedings she would wake up when it was time for her NG. She only changed her behaviour once, which was last night.

DD got her 11:30pm bottle feed and seemed to be still hungry even after 55ccs. Her regular feed should only be 47ccs and her weight gain has been steady, she is now 5lb 8oz. She then refused to go to sleep and I tried every trick I could muster. She has never had trouble sleeping, she had a clean diaper, had been burped, I loved on her, etc. At 1:30am I thought I had her down and the she started screaming. I turned on the light and DD had ripped her feeding tube out! She'd done this a few times before. By 2:00am, she was showing cues she was hungry, so I gave her a bottle early. She downed 30ccs before passing out. We reinserted her NG tube and tube fed her the rest. She then got an NG feed at 5:30am, stayed asleep and then a full bottle at 8:30 this morning.

Her pedi came in and suggested we try something new. Now DD will get fed every 4 hours at a higher volume of 66ccs by bottle every time, and if she can't finish, we'll NG the rest. She then took 45ccs by bottle at 12:30pm and a full 66ccs by bottle at 5:30pm.                                              

I am really hoping this is the push she needs to get the tube gone for good and then we can take her home. Originally we had thought we'd try two bottles in a row to one NG feed but this resulted in an NG top up too many times.
 

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Re: Transition from tube feeding to oral feeding

  • AlwaysSunny925AlwaysSunny925 member
    Switching from feeding every 3 hours to every 4 is what got Aiden to take all his feeds by bottle which was the last requirement for him to go home.  He wasn't hungry every three hours, and if he's not hungry he won't eat.  I hope this is what your LO needs to get rid of that stinkin tube.  Good luck!
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  • paige0328paige0328 member

    For us - unfortunately - there wasn't anything in particular that worked. One day she just "figured it out." I think a lot of it is strength based... we would push for two bottles in a row, and she'd be so exhausted that they would gavage the next two feedings because she couldn't tolerate the bottle. I remember we had a bad couple of days on the bottle, and then the next morning I went in and the nurse said that she took all the feeds by bottle all night... we never looked back and did ad lib feeding from that point forward. 

    I also agree that if she's not hungry, she won't eat. So adjusting to a 4 hour schedule might be what's best. Good luck. She WILL get there!  

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  • jesbethjesbeth member
    Thanks ladies! So far so good, a near perfect 24 hours thus far!
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  • paige0328paige0328 member

    imagejesbeth:
    Thanks ladies! So far so good, a near perfect 24 hours thus far!

    Yay! Fingers crossed for you, let us know how she does! 

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  • JuliaJAGJuliaJAG
    Great thread; I've been wondering this since our son has had quite a few good practice breastfeeding sessions and finally tried bottles for two feedings (and he did great; guzzled them down like a champ and even remembered to breathe most of the time!). Needless to say, DH and I are ecstatic and are daydreaming of him coming home... although both the doctor and the night nurse warned us a lot of preemies have a honeymoon with the bottle where they do great then not so great for a while. So glad to hear your baby is doing so well with it now!
    Julia ~ six miscarriages ~ our sweet miracle baby, Jack, due 5/3/12, was born at 29w1d on February 17, 2012, weighing 2 pounds 8 ounces Lilypie Premature Baby tickers BabyFetus Ticker
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  • snoangel79snoangel79 member

    My kids were feeding by bottle within a few days of eachother. My son ripped the tube out and had to have it replaced then a few days later it was gone for good. Allison was soon to follow (she needed her tube replaced so they took it out). She surprised us all and took to her feedings. They were feeding some bottles and some tube before that. I cannot really tell you how long it took because I was in such a daze. They were in for 3 and 1/2 weeks total so I think the last week they were drinking by bottle. My kids had a pretty uneventful stay. 

    I congratulated you on our board btw not sure if you saw it <: but if not congrats again <: 

    Oct1201212 Twins born at 34w2d, Allison, 3lb,4oz-Ethan, 4lb7oz, both 16 1/2 inches. Out of Difficulties Grow Miracles BestBuddiesBoy AprilPosseMultiLilypie Premature Baby tickers
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  • jesbethjesbeth member
    imagesnoangel79:

    My kids were feeding by bottle within a few days of eachother. My son ripped the tube out and had to have it replaced then a few days later it was gone for good. Allison was soon to follow (she needed her tube replaced so they took it out). She surprised us all and took to her feedings. They were feeding some bottles and some tube before that. I cannot really tell you how long it took because I was in such a daze. They were in for 3 and 1/2 weeks total so I think the last week they were drinking by bottle. My kids had a pretty uneventful stay. 

    I congratulated you on our board btw not sure if you saw it <: but if not congrats again <: 

    I did see it and I replied and then made a post to you, but of course things get pushed back. So thank you again!

     DD has now only had bottles and a full feed each time, for 48 hours now! We should be home by tomorrow! 

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  • snoangel79snoangel79 member
    imagejesbeth:
    imagesnoangel79:

    My kids were feeding by bottle within a few days of eachother. My son ripped the tube out and had to have it replaced then a few days later it was gone for good. Allison was soon to follow (she needed her tube replaced so they took it out). She surprised us all and took to her feedings. They were feeding some bottles and some tube before that. I cannot really tell you how long it took because I was in such a daze. They were in for 3 and 1/2 weeks total so I think the last week they were drinking by bottle. My kids had a pretty uneventful stay. 

    I congratulated you on our board btw not sure if you saw it <: but if not congrats again <: 

    I did see it and I replied and then made a post to you, but of course things get pushed back. So thank you again!

     DD has now only had bottles and a full feed each time, for 48 hours now! We should be home by tomorrow! 

    That's a great update!! How exciting!! I think once "they get it" you are good! haha 

    Oct1201212 Twins born at 34w2d, Allison, 3lb,4oz-Ethan, 4lb7oz, both 16 1/2 inches. Out of Difficulties Grow Miracles BestBuddiesBoy AprilPosseMultiLilypie Premature Baby tickers
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  • shanlubeyshanlubey

    That's amazing news. Sam was so frustrated with bottle feeding, he used a nipple shield to be EBF to come home. We eventually switched him to bottle feeding. 

    I absolutely detested feeding those first couple of weeks of trying. 

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  • PregsterDDPregsterDD member

    Thanks ladies, I needed to read this.  My LO was born March 13th at 33 wks and is now 36 weeks. He will not take the bottle but half of the time. We have had some "honeymooning" going on. I have my hopes up so high that the switch will flip and he will take every feeding.  I want him home by Easter so badly!  

    Also, the neo is talking about syringe feeding him...anyone have experience with this? 

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