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Maybe ask about scholarly evidence on the safety of bottle feeding? (I’ve seen late preterm babies get terribly apnic and bradychardic when being bottlefed.)
Holly McSpadden, IBCLC
Get Outlook for iOS<https://aka.ms/o0ukef>
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From: Lactation Information and Discussion <[log in to unmask]> on behalf of Christina Zimpfer <[log in to unmask]>
Sent: Tuesday, March 8, 2022 5:32:38 PM
To: [log in to unmask] <[log in to unmask]>
Subject: Research supporting finger feeding in the NICU
Our NICU is reviewing all things feedings, and finger feeding is being questioned as not evidenced based/ dangerous. 2 different populations we use fi get feeding with:
Closer to term: We typically use finger feeding as a bridge waiting for breastfeeding skills to improve or for mom to physically get here, or for babies who are staying on the NICU a short time and are hopefully transferring back to postpartum (ex: chorio, hypoglycemia, etc)…. i.e. babies who, if we just give them a few days to figure it out they could squeak by without a bottle.
Late preterm: We don’t typically finger feed babies with gavage tubes, to save their energy for latching. Our guidelines state babies above 34 weeks can finger feed, but we typically don’t that young (unless a baby is showing strong oral cues and mom isn’t available, and mom plans to latch). I think this is the population that staff are questioning whether finger feeding is safe developmentally; lots of concern about aspiration.
I will say, as a global statement, our staff does NOT like finger feeding nor do nurses advocate for it for appropriate populations. Our OTs don't “do” finger feedings (only bottles) so they don’t see the value (although most are very supportive of latching and breastfeeding).
I’m thinking this is an attempt to completely ban the practice.
Any scholarly research and evidence would be much appreciated…
Another request: if your NICU successfully uses finger feeding, what equipment you use? Currently we use a 5 Fr gavage tube with a syringe where staff have to proactively push on the plunger when baby sucks (I think that’s part of the problem of people complaining about safety…. Overzealous plunger pushing with sleepy babies who shouldn’t be finger feeding at all). We occasionally use a Medea SNS system as well. I have encouraged buying an appropriate finger feeding apparatus to no avail.
Christina Zimpfer RNC, IBCLC
Lactation Consultant
NICU-IMC Unit Council Member
Neonatal Intensive Care
M Health Fairview | University of Minnesota Masonic Children’s Hospital
2450 Riverside Ave | Minneapolis, MN 55454
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Office: 612.273.7624
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