I have a question about recommendations about cleaning the 5 french tubes when used as an SNS.  The cited article by Dr. Newman recommended rinsing the feeding tube out with hot water only (aspirating hot water up the tube). and hanging to dry.  Soap was optional.  The article also mentioned the same tube could be used for about a week.

What cleaning recommendations are others providing?  I'm a bit concerned that the feeding tube would be a lovely source of infection (yeast and other critters) with the hot water only cleaning recommendation.

As for feeding patterns for babies with congenital heart disease.  Feeding requires a pretty significant expenditure of energy.  In fact one of the screening questions I ask about a baby with heart disease is does the baby tire out with feeding (as well as does the baby sweat with feeding).They can even take a long time to bottle feed  an hour feeding 1-2 oounces (even though bottle feeding relies primarily on gravity)  Often these babies need supplemental feeding with some sort of concentrated feeding (24 kcal/oz, 27 kcal/oz).  I've seen some of my patients sent home from the tertiary care center (100 miles away we do not have specialized pediatric services locally) on  home gavage feeding (with oral gastric feeding tubes).  I am sure the babies are not thrilled to have an OG tube indwelling, but in some instances they are not able to establish adequate weight gain for growth (and be ready for reparative cardiac surgery).

Definitely a challenging situation for baby, family and the health care providers.

Pierrette Mimi Poinsett, MD FAAP
Modesto CA

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