Nutrition & Feeding

I am in the process of updating our present policy on orogastric and nasogastric tube feeding and am looking at the size of tube in relation to the size of the infant. A few different opinions I have come across are that infants under 800, 1000 or 1200 grams should use a size 5Fr and over 800, 1000, or 1200 grams should use a 6Fr., however, I cannot find any research to justify if any of these weights are correct. What standards does your unit use and do you have research to justify your reasoning? Thank you.

Do any European colleagues have information about the stability of Omegaven 10% in syringes? We have a 3 kg baby ordered about 30 mL/day and if we could subdivide a 100 mL bottle into 3 portions it would be much more cost effective. This baby will be on very long-term TPN having lost most of the bowel after gastrochisis repair, then necrotic bowel was resected. Thanks, Connie Harris, Pharm.D, NICU - VGH, Victoria, Canada

I am writing a new guideline for nasogastric feeding, to include confirming placement of an ng tube. I would like to dictate the use of a 10ml syringe for aspiration because of the lower pressure but I cannot find the evidence base related to this. There are many other guidelines stating the use of 10ml syringes, but again they do not include any evidence base. Can anyone point me in the right direction please?

I woulg like to know the opinion and experience of others in method of tube feeding in nicu. 1 . Tube feeding oro-gastric, tube is removed every time after feed. 2. onasogastric feeds, tube remains ther. 3. orogastiric, tube is passed from mouth ,is fixed on face and intermittent feeds are givem by nursing staff. Ihave seen some units are very comfortable with this method ,but fear is of displacing the tube with some activity. thanks

What cutoff range of osmolarity do institutions out there use when switching from central route to peripheral route? (What is the maximum osmolarity allowed for peripheral infusion of TPN in a neonate?).

Dear all, Many hospitals now are going to be Baby Friendly as per Baby Friendly Hospital Initiative (BFHI) and WHO protocols. I strongly suggest to make our favorite website 99nicu.org a Baby Friendly Website. What do you think? Regards

Hello group, This is my third try at posting a message. Here in Victoria, west coast of Canada, we've developed a teaching DVD, 9 minutes long, to encourage mothers of breastfed infants to give their babies Vit. D. We made it in-house using staff moms and babies, and also mothers from the Native Friendship Centre, to try to give it a multi-ethnic flavour. It's posted on Google videos at the above link so you can have a look although the quality on google is not so good. If anyone would like to order a copy our audio-visual dept will sell them for about $22 CDN, including postage etc.to anywhere. It was made as part of a hospital pharmacy residency research project. We …

Hi how and which posology of vitamines do you use for TPN of the preterm, especially the Vitamine D. thanks

Dear collegues, In our NICU we find hyperlicemia in many premies. We find it in almost all the babies <25 weeks, but also in many >27-28 weeks. Our TPN protocol consists (in first day of life) in 6 mg/kg/min of glucose, 1g/kg of Intralipid 20% and 1 g/kg of AA. It's, more or less, similar of others TPN protocols. Do you resolve hyperglicemia reducing glucose administration before, or dou you start insuline immediately? Best regards Marcello De Filippo, MD Subintensive care unit University of Siena, Italy

Dear NICU colleagues, I want to know whether the use of in line filters during administration of TPN fluids is standard practice in all NICUs? I also want to know what brand of Filter do you all use ? I would also like to find out how your experience has been with the filters that you use ? (pros and cons) Furthermore i am keen to find out whther you 'piggyback' the intralipid to the Dex/AA solution ( that is connect the intralipid to the same line as Dex/AA solution) or give the intralipid seperately? As for our centre, we do use in line filters during administration of all TPN fluids. The only filter that is available to us from the hospital management is BAXA sy…