Breastfeeding infants nearing discharge whose mothers can’t lodge in hospital. known gastrointestinal anomaly orobstruction). A high-risk infant is an infant that appears well but has a much greater chance than most infants of developing a clinical problem, such as hypothermia, hypoglycaemia, apnoea, infection, etc. Infants with an uncoordinated suck, swallow, and apnea) Limited endurance Poor suck/swallow/breathe coordination Following individual clinical assessment, infants may commence feeds at 60-90ml/kg/day divided into 3hly feeds as soon after delivery as possible. Standard risk infants ≥32 weeks with no ‘high risk’ clinical indicators. Therapeutic feeding strategies (e.g. 2. High-risk infants appear clinically well on examination. Feeding concerns for high-risk newborns at discharge Preterm infants may have many of the following feeding problems at discharge: State instability (e.g. Preterm infants too immature to breast feed or unable to complete a breast feed, or whose mothers were not present at the time of a feed. HIGH RISK NEONATES Presented by Ann Hearn RNC, MSN Preterm < 37 wks SGA below 10th percentile Late preterm 34.0 36.6 wks AGA Between 10th & 90th ... – A free PowerPoint PPT presentation (displayed as a Flash slide show) on PowerShow.com - id: 3d26f0-Mzk1N Module: Enteral feeding of the High. premjis@ucalgary.ca View High Risk Newborn Fa 2020 (1).ppt from NURS 471 at Southeastern Louisiana University. This policy statement updates the guidelines on discharge of the high-risk neonate first published by the American Academy of Pediatrics in 1998. • Dunn Michael S. The Golden Hour. Guidelines for Perinatal Care, 6th ed 2007. • McNamara PJ, Mak W, Whyte HE. Feeding infants at high-risk of aspiration/ apnea during feeds 5. AAP Perinatal Section website. Giving High-risk Neonates the best possible start. in the newborn period. As with the earlier document, this statement is based, insofar as possible, on published, scientifically derived information. Enteral feeding for high-risk neonates: a digest for nurses into putative risk and benefits to ensure safe and comfortable care. difficulty transitioning from a sleep state to an awake state) Physiological instability (e.g. General bottle feeding approach in low-risk infants 4. J Perinat Neonatal Nurs. 3. 2005 Jan-Mar;19(1):59-71; quiz 72-3. 1. Premji SS(1). external pacing) 8. Therapeutic feeding compensations 6. Signs • American Academy of, Pediatrics. Risk Newborn - Session 1 Competency Based Training Module for Physicians Neonatal Health Care Modules Enteral Feeding of the High Risk Newborn Jayashree Ramasethu, M.D. Nursing Care of the Compromised Newborn Erin Hoffman, RN, MSN Birth Trauma Caput 1. ACOG (eds). Logistics of managing therapeutic feeding equipment 10. Infants with a cleft lip and/or palate before surgery 4. (gavage) feeding until neonate is well enough to feed orally OR is physiologically able (i.e. Although most episodes resolve spontaneously and without sequelae, any signs of feeding intolerance should be regarded as potentially serious because of the increased risk of NEC among these infants. Assess the infant’s feed tolerance at least twice daily, before making each increment in feed volumes. Author information: (1)Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada. 3. Therapeutic feeding positioning 7. suck / swallow from 34 weeks) Issues in the preterm neonate– ‘Trophic’ feeding (minimal enteral nutrition (MEN) with breast milk to prime the gut), Non nutritive sucking – neonate has pacifier to get used to stomach filling during a gavage feed Therapeutic feeding equipment 9. High-risk infants appear well but have an increased risk of complications. 8.2.For infants with birthweight greater than 2.5 kg, determine nutrition based on assessment of infant’s history, condition and tolerance of feeds. 8.1.Initiate enteral nutrition for all infants as soon as possible or within 6 hours of birth unless there are contraindications to feeding (i.e. most such infants will have episodes that require either temporary discontinuation of feedings or a delay in advancing feedings. Georgetown University Hospital Washington, D.C. 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