Babies born prematurely need time to develop the ability to suck and swallow, while breathing. If the baby is born around week 30 of pregnancy, it can sometimes learn to coordinate sucking, swallowing and breathing after just a few weeks. When the baby is born very prematurely and/or if it has respiratory problems, it can take much longer. Even babies who are not born prematurely, but who are sick when they are born may initially have difficulty feeding. In order to get nutrients into the baby, it will have to be tube fed while it is practising how to feed.
The feeding tube is lowered into the stomach via a nostril. To ensure that the feeding tube has not moved and remains in the correct position, it must be checked before each feed.
Feeding your baby
How fast or slow the baby wants its food varies with each baby. A general rule is to gently inject 1 millilitre of breast milk/baby formula per minute. However, some babies are hungry at the start of the feed and start to fret if they do not get the first few millilitres quickly. Some babies need to feed slowly, so as not to feel sick. The approximate time it takes for a feed is between 20 and 40 minutes for larger amounts of milk.
If the baby needs to take any medication, it is advisable to give the baby the medication when it has got a little milk in its stomach. If your baby needs to take a number of different medications, it is advisable to administer them in stages throughout the feed.
Concluding tube feeding
When the feed is over, inject 0.5-1 millilitres of air into the tube to clean it.
Checking the position of the feeding tube
- Ensure that the marking that shows how far down the tube should sit is visible at the wing of the baby's nose
- Check that the tube is firmly attached to the baby's cheek
- Aspirate (pull) slowly and gently with a small syringe until a small amount of fluid from the stomach is visible in the tube (about 0.5-1 millilitres)
If you encounter problems whilst checking the feeding tube
Sometimes it can be difficult to get any fluid from the stomach. This may be due to several reasons. For example, the stomach is completely empty or the baby is lying in a position where the tube cannot reach the fluid contained in the stomach. The tube can sometimes be lying against the wall of the stomach when you are checking its position. Occasionally, the tube may move upwards from the stomach via the oesophagus and is too high up, then there is a risk of the milk ending up in the trachea.
Never use the feeding tube if you are not sure that the tube is in the correct position Contact the staff and they will help you to check the position of the tube