Nipple Feeding

Question

I am looking for any ideas for encouraging nipple feeding. My daughter did well with a nipple for her first four days. After many nipple and formula changes, reflux issues, and low oxygen saturation (OS) after feeding, she quit nippling almost completely. Most of her formula is via Nasogastric (NG) Tube. She gets a high calorie soy formula and the reflux is better. The doctor has mentioned Percutaneous gastrostomy (PEG) tube placement. We want her home with us, but can't give up on nipple feeding yet. Do you have any ideas that might help her return to nippling? I know even with the PEG we can still work on nippling. Is this something she can learn? She was on Reglan, but that was discontinued because of OS.

Answer of our experts

There are lots of ways to work on it. Getting the PEG tube may actually help for a number of reasons. Most babies nipple OK with an NG tube in but some do not. Most children's hospitals have speech therapists or OT specialists in feeding who may help

If fatigue is an issue, it may help to try nippling only a few times a days when she is really awake. Nippling just before a feed helps. Babies can be drip-fed at night and then allowed to eat during the day. That keeps them hungry. It may also help to go back on the Reglan. After a couple of weeks of age, the babies produce more acid and the reflux hurts more, causing them not eat as well

CP/TK 7-13-10

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Recommendation(s)

Feeding and Dental Difficulties

R12

In every CdLS individual with prolonged and marked feeding difficulties, the multidisciplinary assessment (from healthcare workers across many disciplines) should consider (temporary) placement of a gastrostomy (surgical opening through the abdomen into the stomach) as a supplement to oral feeding.

R13

In individuals with CdLS who have recurrent respiratory infections, reflux and/or aspiration (breathing foreign objects into airways) should be ruled out.

R14

The palate should be closely examined at diagnosis. In case of symptoms of a (submucous) cleft palate, referral for specialist assessment is indicated.

R15

Dental assessment and cleaning should take place regularly; a more thorough dental examination or treatment under anaesthesia may be necessary.

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