Hi All,

I am looking for information about orally feeding infants while on nasal CPAP. What are your NICU's doing? Does anybody know of any research supporting it or not supporting it?

We have twins (ex-25 weekers, now 44 weeks GA) who have not been able to tolerate transitioning to nasal cannula. They remain on nasal CPAP and our medical team is asking about oral feeding.

I would welcome any information that anyone has.

Thanks!

As long as they are resonably stable we allow both breastfeeding and bottlefeeding while on CPAP.

Breastfeeding is usually easier, since the baby can kontroll the flow and her/his own work better. It can be a problem having the right equipment that allows enough room to be close enough to the breast!

Anna

hello kloud,

usually it is not a problem, but....

NCPAP has it´s indications. feeding infants by bottle, as you know, also has it´s prerequisites. Our recommendations are that the infants that can be fed by bottle have to be normopneic, with no other signs or symptoms of respiratory distress. It is well known that even for "healthy" premature infants, establishing a normal suck- swallow- breath- pattern with nutritive sucking is often challenging and energy consuming.

So in our case, we only feed our NCPAP- Kids, when they are at the threshold between NCPAP and low- flow- nasal cannulae.

For some infants the benefit of feeding them by bottle (or breast) is worth the limited time the infant experiences some degree of respiratory distress after feeding. Some of our infants in that group are simply much more quiet and satisfied, when they are fed by bottle instead of the feeding tube.

hope that helps

Hi Kloud

As long as our babies are stable, usually after the first 48 hours, we allow them to grade up on feeds. We don't usually allow suck feeds (breast or bottle) until they are tolerating some time off CPAP.

many thanks

Jackie

Same remarks as Smithjackie

Hello Khloud

As long as baby is stable ; normal blood gases and no frequent apnea , normal abdominal girth ,we can start feeding .

Breast feeding/ or bottle feeding when baby can tolerate some time without NCPAP ; during that time we supply nasal oxygen and observe baby's color ,oxygen saturation and respiratory effort .

Safaa

Hello Kloud,

We also don't usually allow suck feeds (breast or bottle) until they are tolerating some time off CPAP.

Thereby they have to be -at least 32 weeks for breastfeeding and 34 weeks for bottle feeding

Petri

To maintain NCPAP while allowing to breast feed is difficult and most of the times in our experience it causes instability in oxygen saturations while trying to do so.We allow pallada feeds ( a traditional small cup with a volume of 15-20ml with a feeding sprout small enough to feed small babies in India) with good success.If baby is neurologically with no deficits pallada feeding becomes successful otherwise we continue orogastric tube feeds.

it's worthy to give some drops of human milk to the babies in nasal CPAP also when they are fed through an oro-gastric tube.