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


  • 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