gavage feeding of the newborn

gavage feeding of the newborn

a procedure in which a tube passed through the nose or mouth into the stomach is used to feed a newborn with weak sucking, uncoordinated sucking and swallowing, respiratory distress, tachypnea, or repeated apneic spells.
method After the gastric tube is inserted, its placement is checked by radiography or by instillation of air and auscultation of the stomach for air sounds or by immersion of the proximal end of the tube in water. If the amount of residual formula left in the infant's stomach at the time of the next feeding exceeds the quantity specified, the next feeding may be delayed or omitted. Blue food coloring is often added to the gavage to distinguish gastric contents from respiratory secretions to help detect aspiration of gastric contents into the lungs. During feeding the infant is held in a low Fowler's position, preferably by the mother, and is restrained only if necessary. The feeding syringe is held 18 centimeters above the infant's head, and the flow is initiated by pressure on the plunger. As the formula is slowly instilled, the baby is stroked and is offered a pacifier to promote gravity flow, exert a calming effect, and reinforce the relationship between sucking and feeding. If the infant gags, spits, chokes, regurgitates, vomits, or becomes cyanotic, the rate of flow of formula is reduced, and the feeding may be stopped. To prevent air from entering the stomach when the feeding is completed, the tube is pinched closed as it is withdrawn. The infant is burped gently by patting or rubbing the back and then positioned on the right side in the crib. Postural drainage and percussion are avoided for at least 1 hour after feeding. The time, amount, and kind of feeding and the size of tube used are entered in the nursing care plan.
interventions The nurse administers intermittent gavage feeding to the infant, explains the need for the procedure to the parents, and explains that nipple feedings may be instituted when the infant sucks on the gavage tube or pacifier, actively seeks nourishment, shows good suck and swallow coordination, gains weight, and has a respiratory rate of less than 60 breaths per minute.
outcome criteria Intermittent gavage feedings can enable the high-risk infant to survive.