Performing a test feed is a clinical procedure used to assess a newborn or infant’s ability to suck, swallow, and breathe in coordination during feeding. It helps identify feeding difficulties, aspiration risk, and readiness for oral nutrition
Definition
Performing a test feed is a clinical nursing procedure used to assess a postoperative patient’s tolerance to oral intake, especially when a nasogastric (NG) tube is in place. It helps determine whether the gastrointestinal tract has resumed function and if the patient is ready to transition to full oral feeding.
Purposes
- Detect aspiration, regurgitation, or choking
- Assess nutritional readiness post-surgery or illness
- Monitor neurological or anatomical abnormalities (e.g., cleft palate, hypotonia)
- Guide decisions on enteral vs. oral feeding
Articles
A clean tray containing:
- Towel.
- Ounce glass.
- Glass with water.
- Kidney tray.
- Syringe-20 mL
- Prescribed feed (breast milk or formula)
- Sterile feeding bottle or syringe
- Suction apparatus (if needed)
- Pulse oximeter (optional)
General Instructions
Number of feeds, quantity of each feed, and time of aspiration may differ according to surgeon’s order.
Before the Procedure
- Verify physician’s order and feeding plan
- Explain the procedure to caregivers
- Ensure the infant is calm, alert, and slightly hungry
- Gather equipment:
Procedure
| NURSING ACTIONS | RATIONALE | |
| 1. | Before procedure Check Physicians order. | Determines the type of feed. |
| 2. | Explain to the patient regarding purpose of test feed and how it will be performed. | Helps in obtaining cooperation of patient. |
| 3. | During procedure Aspirate nasogastric tube. | Determines the amount of gastric contents present. |
| 4. | Measure amount of water to be given, as per doctor’s order. | |
| 5. | Offer measured quantity of water every hour for 4 hours. | |
| 6. | Before giving fifth feed aspirate stomach contents, note the quantity. | Assesses patient’s tolerance for feed. |
| 7. | If patient develops vomiting, discontinue test feeds and inform physician. | |
| 8. | After procedure Record in nurse’s record and intake and output chart. | Recording aids in communication among health team members. |
Documentation Checklist
- Type and amount of feed offered
- Duration and tolerance of feed
- Reflexes observed (sucking, swallowing, breathing)
- Signs of aspiration or distress
- Interventions performed (e.g., suctioning, repositioning)
- Parental education provided
Special Considerations
- Use modified nipples or feeding techniques for infants with cleft lip/palate
- In preterm or neurologically impaired infants, consider paced feeding or gavage
- Monitor oxygen saturation if aspiration risk is high
- Collaborate with speech therapists or lactation consultants for feeding plans
- Document findings and notify physician if abnormalities are observed
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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