Indwelling Versus Intermittent Feeding Tubes in Premature Neonates

Authors

  • Amanda Symington RN, MHSc,

    Corresponding author
    1. Amanda Symington is a clinical nurse specialist/neonatal practitioner at Chedoke-McMaster Hospitals and clinical lecturer, School of Nursing, McMaster University, Hamilton, Ontario, Canada.
    Search for more papers by this author
  • Marilyn Ballantyne RN, MHSc,

    1. Marilyn Ballantyne is a clinical nurse specialist/neonatal practitioner at the Hospital for Sick Children, Toronto, Ontario, Canada.
    Search for more papers by this author
  • Janet Pinelli RN, MScN,

    1. Janet Pinelli is an associate professor in the School of Nursing at McMaster University and a clinical nurse specialist/neonatal practitioner at Chedoke-McMaster Hospitals, Hamilton, Ontario, Canada.
    Search for more papers by this author
  • Bonnie Stevens RN, PhD

    1. Bonnie Stevens is an assistant professor at the University of Toronto and a nursing research consultant at Mount Sinai Hospital, Toronto, Ontario, Canada.
    Search for more papers by this author

Address for correspondence: Amanda Symington, RN, MHSc, Neonatal Intensive Care Unit, Chedoke-McMaster Hospitals, 1200 Main Street West, Hamilton, Ontario L8N 3Z5.

Abstract

Objective: To determine the effect of indwelling versus intermittent feeding tube placement on weight gain, apnea, and bradycardia in premature neonates.

Design: Eligible subjects were assigned randomly to either feeding tube method. Each subject was followed for 6 days.

Setting: The study was conducted in a secondary level neonatal intensive-care unit (NICU), a tertiary level NICU in a perinatal center, and a tertiary level NICU in a referral center.

Patients/Participants: Neonates who were 24–34 weeks gestational age, developmentally appropriate for gestational age, medically stable, on full enteral feedings through an orogastric or a nasogastric tube, and not fluid restricted. Ninety-three neonates were enrolled-49 in the indwelling group and 44 in the intermittent group. Nine neonates did not complete the study.

Interventions: Nasogastric indwelling feeding tubes were placed and left in site for up to 3 days. Orogastric intermittent feeding tubes were placed for each feeding and removed at completion of the feeding.

Main outcome measures: Weight gain, apnea, and bradycardia. Results: Members of both groups had similar demographic characteristics, clinical problems, and nutritional intake. No statistical differences were found between the two groups in weight gain or episodes of apnea and bradycardia.

Conclusions: There were no statistically or clinically significant differences between the two groups. The intermittent method of feeding is more expensive. Because no clinical differences were found, the type of tube placement chosen for feeding the premature infant may be based on economics.

Ancillary