Good afternoon!

I am meeting with our neonatologists on this upcoming Thursday about putting in maximums for full term infants that are brought to our NICU due to suspected/confirmed chorio, meconium, etc.   Frequently, a neo will put in an "ad lib" order for feeding and request that the baby starts eating to bring them off the IV fluids.   An ad lib to one nurse can mean something completely different to another nurse.  I have been educating, but will still come in to find an occasional first feed being 25 mL during the first 24 hours.  As you can imagine, this can cause days of working backwards to get the infant back to the breast.

So, for any NICU staff out there, do you have any true research articles on appropriate feeding amounts when you are trying to wean off TPN?  Do you have documentation about what your hospital is doing?  Is it backed by anything?  I have been having a hard time finding research to bring into the NICU as I know my doctors are going to want reasons even if they cannot give me reasons for ad lib.

I know what we would recommend in a Mother Baby setting without the introduction of IV and TPN, but are there any firm numbers out there when antibiotics, IVs, etc. are also included in the baby's first days?

Thank you in advance,
Amy Black, IBCLC

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