Posted 11 June 2007 - 01:20 PM
We are searching for consensus for re-feeding residuals; breast milk or formula-
What is your protocol regarding residuals and the extremely pre-term infant?
All views and opinions and data would be considered.
Thank you in advance!
Renee Addy, RNC
UCONN Health Center
Posted 16 June 2007 - 04:09 PM
in our unit, we use brest milk of the natural mamma in the majority of cases. some times where this is impossible to do it, we use a formula for preterm with 10-13% concentration. after initialisation of gastro-duodenal feeding, and after making sure that there is not enteropathy, we try to use a higher concentration: progressively from 13 to 20%. for preterm with brest feeding, we use a solution of eoproteine to concentrate 2-4%.
Posted 25 June 2007 - 09:21 PM
If residuals looks greenish or otherwise "unfresh" we usually throw it away, and skip the planned feed. Depending on other clinical signs, residuals also later (despite the skipped feed) we handle each case individually. But we are quite scared of NEC in the ELBW infants, and it is not uncommon with a rather careful feeding strategy.
Posted 27 June 2007 - 01:49 PM
Posted 29 June 2007 - 01:46 AM
Posted 03 July 2007 - 06:16 AM
In our unit once hemodynamicaly stable and normoxemic we start on intermittent bolus feeds Q3h at 10ml/kg/day and increase by 10-20ml/kg /day.We dont refeed the residuals and are discarded.We check stools for occult blood and monitor abdominal girth also
Dr.V.Lakshmi Neonatologist,Mehta`s Children Hospital,Chennai,India
Posted 03 July 2007 - 01:36 PM
we are re-feeding elbw infants with residuals less than %30 amount of milk or formula . if it is more than % 30 and greenish or yellow in colour we are throwing it away and skip the planned feeding.if residual is clear stomach secretions we are putting back because of decrease hydrochloric acid concentration and hypochloremic alkalosis.