Infant Malnutrition (FTT) — Secondary Feeding Recommendations — Clinical Pathway: Inpatient

Infant Malnutrition/Failure to Thrive (FTT) Clinical Pathway — Inpatient

Secondary Feeding Recommendations

Consider the following recommendations for patients who are not gaining adequate weight or meeting intake goals.

Secondary Feeding Recommendations for Patients with Inadequate Weight Gain

Status Feeding Recommendations
Patient able to tolerate goal feed volume
  • Increase volume by 10% to max 180 mL/kg/day
  • or
  • Increase caloric density of feeds by 2 kcal/oz (max 24 kcal/oz)
  • Considerations:
    • Allow at least 24 hours to assess tolerance to feeding changes
    • Babies with significant reflux may not be able to handle increased volume
    • Increasing caloric density will require caregivers to learn a new formula mixing recipe
    • If maximums are met without problem resolved, discuss with Clinical Nutrition
  • Discuss changes with Clinical Nutrition.
  • Continue to reassess tolerance with changes to feeding regimen.
  • If patient is taking significant amount of solids and > 9 months, consider calorie boosting of solids.
If patient is not able to consistently and safely take enough by mouth to gain weight
  • Consider NG feeds
    • Discuss with Clinical Nutrition for specific recommendations
    • Notify Case Management to coordinate supplies
    • Arrange family education

  • Determine who will manage tube feeds outpatient. Assess if PCP is comfortable managing feeds; if not, consider GI or Feeding Team for management.
  • Note: Inpatient Speech generally provides referrals for Outpatient Feeding Team