Protecting Breastfeeding by Facilitating Safe, Early Discharge from NICU with Home Nasogastric Tube Feeding
While approximately 80% of UK mothers initiate breastfeeding, by 3-4 months, just 15% of infants receive any breastmilk. Despite the low rates of breastfeeding nationally, in 2021-22, 64% of the NICU graduates in our unit were discharged receiving breastmilk. One possible reason for the higher rates of breastfeeding in this population may be our innovative home NGT feeding programme. In order to hasten discharge from NICU, many mothers feel under pressure to introduce bottles to meet “full oral feeding” criteria. The home nasogastric tube (NGT) feeding programme focusses on the infant’s and family’s needs, without rushing the infant towards full oral feeding, which some are not yet ready for. In this way, all oral feeds can be at the breast, with NGT feeds as required for supplementation. We aim to reduce unnecessary days in hospital, reduce readmissions post-discharge, keep families close to their infants, and embrace the integration of families as essential members of the neonatal care team. This presentation will discuss the practicalities of designing a discharge pathway that optimises parental confidence and ensures competence with home administration of NGT feeds. It will also discuss how to predict which infants are ideal candidates for short-term home NGT feeding, and how to transition to direct breastfeeding. Finally, the presentation will present a case for home NGT feeding as an intervention to protect the mother’s breastfeeding goals, optimise clinical outcomes for infants, and improve the experience of neonatal care for families.
This presentation was originally offered at our GOLD Neonatal Online Conference 2023.
Amanda is a children's nurse, having worked on pediatric wards and in the community supporting children with complex health needs, although over ten years of her nursing career have been in neonatal care, where she is further qualified in specialty (QiS). She trained and volunteered in breastfeeding peer support two years into her nursing career, ultimately sitting the exam to become an IBCLC to ensure that the families within neonatal care had access to an infant feeding specialist familiar with their journey. Amanda has since further specialized in Neonatal Homecare, is a Nurse Practitioner in restrictive lingual frenulum, and has worked as an Infant Feeding Lead for a regional surgical NICU and SCBU, as well as a regional Infant Feeding Advisor to ten neonatal units across a regional network. She has recently been appointed to the Board of Trustees for the Lactation Consultants of Great Britain (LCGB), where she is the Neonatal Lead.
1. Describe how to develop a discharge pathway for a home NGT feeding programme.
2. Explain the criteria for an ideal home NGT feeding candidate.
3. Describe how home NGT feeding can be protective of breastfeeding goals, before and after discharge from NICU.
While approximately 80% of UK mothers initiate breastfeeding, by 3-4 months, just 15% of infants receive any breastmilk. Despite the low rates of breastfeeding nationally, in 2021-22, 64% of the NICU graduates in our unit were discharged receiving breastmilk. One possible reason for the higher rates of breastfeeding in this population may be our innovative home NGT feeding programme. In order to hasten discharge from NICU, many mothers feel under pressure to introduce bottles to meet “full oral feeding” criteria. The home nasogastric tube (NGT) feeding programme focusses on the infant’s and family’s needs, without rushing the infant towards full oral feeding, which some are not yet ready for. In this way, all oral feeds can be at the breast, with NGT feeds as required for supplementation. We aim to reduce unnecessary days in hospital, reduce readmissions post-discharge, keep families close to their infants, and embrace the integration of families as essential members of the neonatal care team. This presentation will discuss the practicalities of designing a discharge pathway that optimises parental confidence and ensures competence with home administration of NGT feeds. It will also discuss how to predict which infants are ideal candidates for short-term home NGT feeding, and how to transition to direct breastfeeding. Finally, the presentation will present a case for home NGT feeding as an intervention to protect the mother’s breastfeeding goals, optimise clinical outcomes for infants, and improve the experience of neonatal care for families.
Accreditation
CERPs - Continuing Education Recognition Points
Applicable to IBCLC Lactation Consultants, Certified Lactation Consultants (CLCs), CBEs, CLE, Doulas & Birth Educators. GOLD Conferences has been designated as a Long Term Provider of CERPs by IBLCE--Approval #CLT114-07. This program is approved for 1 L-CERP.
CMEs - Continuing Medical Education Credits for Physicians & Nurses
The AAFP has reviewed the activity and deemed it acceptable for AAFP credit. Term of approval is from 05/30/2023 to 05/30/2024. Physicians should claim only the credit commensurate with the extent of their participation in the activity. This activity is approved for 1 AAFP Prescribed CME credit.
Nursing CEUs - Nursing Contact Hours
This nursing continuing professional development activity was approved by the American Nurses Association Massachusetts, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation for 1 Nursing Contact Hours.
- View this presentation in its entirety, under your individual GOLD login info
- Successfully complete a post-test (3 out of 3 questions correctly answered)
- Fill out the Evaluation Survey
If you have already participated in this program, you are not eligible to receive additional credits for viewing it again. Please send us an email to [email protected] if you have any questions.
Additional Details
Viewing Time: 2 Weeks
Tags / Categories
(IBCLC) Development and Nutrition, (IBCLC) Pathology, (IBCLC) Psychology, Sociology, and Anthropology, Breastfeeding Strategies for the Preterm Infant, Discharging From NICU
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