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PROTOCOL ON PALADAI / SUTHI FEEDING

Aims​

To ensure safe practices of feeding of newborn.

Responsible​

Nursing staff. Ideally to be performed by parents of baby.

A paladai is a small bowl with a long pointed lip traditionally used for feeding low birth weight infants. A paladai is a simple and effective tool to use when feeding babies who are not able to suck directly at the breast. It can serve as an intermediate step between gavage and breastfeeding. Additionally, it reduces the risk of infection, it is also useful in most cases of cleft lip and palate, and it is easy to follow and socially acceptable.

Indications​

  • Babies at the age of 32-34 weeks or term babies in situations where mother is unable to feed.

The coordination of suck, swallow, and breathing emerges at around 32-34 weeks of gestation age.
One should also consider the presence or absence of sickness and individual feeding efforts of the baby to decide how a LBW baby should be provided feeding.

Equipments​

  • Paladai / Suthi
  • Milk
  • Cotton napkin

Procedure​

  1. Wash hands and dry.
  2. Make sure baby is awake.
  3. Place the infant in up-right position on mother’s lap, caregiver’s lap or in the crib.
  4. Keep the cotton napkin around the neck to mop up spillage.
  5. Take the required amount of expressed breast/ formula milk by using a clean spoon or sterile syringe. Fill the paladai with milk, a little short of the brim.
  6. Hold the paladai spoon by its sides. Do not put your fingers in the milk.
  7. Place it at the lips of the baby at the corner of the mouth.
  8. Tip the paladai to pour a small amount of milk into the infant’s mouth.
  9. Feed the infant slowly, he/ she will actively swallow the milk.
  10. Repeat the process until the required amount is given.
  11. If the baby does not actively accept and swallow, try to arouse the baby with gentle stimulation. If the baby is sluggish, do not continue with paladai feeding. Give gavage feed instead.
  12. Burp the baby.
  13. When estimating the milk intake, deduct the amount of the milk left in the cup and the amount of estimated spillage.
  14. After use, wash the paladai with soap and water and put it in boiling water for 10 minutes to sterilize before next feed.

References​

Neonatal Intensive Care by Merenstein and Gardner, 7th edition (2011), Neonatology Protocols by Indian Journal of Pediatrics, New Delhi, India (2013), Dr. Deorari, Paul, Singhal, Scotland and Mcmillian, Practical procedure for the newborn nursery. 3rd edition (), and www.newbornwhocc.org/module 3/ feeding normal and LBW babies.

Document Information​

Archived Version

Version: 1.0 (Archived)
Published: August 3, 2015
Contributors: Nurse Ajeeta George, JK Lone Hospital, SMS Medical College, Jaipur
View: Current Version