Post-N/IICU Inpatient BPD Clinical Pathway
Feeding and Nutrition
Feeding Schedule
- Transition from continuous feeds to more physiologic bolus feed regimen, if tolerated
- Condense towards bolus feeds gradually
- Ensure that discharge regimen is feasible in a home setting
GERD
- Generally, a clinical diagnosis
- Tailor management decisions to reflect the impact of GERD on the patient’s respiratory status, feeding tolerance, and comfort
Oral Stimulation and Feeding
- Consult Speech Language Pathology (SLP) to evaluate for oral feeding readiness, once O2 support is weaned to 2 LPM
- Consider swallow study if there is clinical suspicion for aspiration
- May consult SLP for oral stimulation prior to O2 wean to 2 L
Enteral Feeding Tube Consideration
- Consider surgical/IR placement of G-tube if need for long-term enteral access is anticipated
- Consider fundoplication if patient has severe GERD impacting respiratory status or evidence of aspiration from below