Transitioning from gavage to full oral feeds in premature infants: When should we discontinue the nasogastric tube?

The optimal timing for discontinuation of nasogastric (NG) tube in premature infants transitioning to oral feeding is not known. To determine whether early removal of NG-tube is appropriate in low-risk premature infants. Prospectively collected data of premature infants started on oral feeds at ≤34 weeks gestation were reviewed. Infants were categorized into ‘early’ or ‘late’ NG-removal groups based on the proportion of oral intake in the preceding 2-days, i.e., 60–79% or 80–100% of the total volume, respectively. In total 50 infants in early group vs. 43 in late group. Both groups had similar oral intake and weight change in the subsequent 2-days post-NG removal. The days from NG-removal to target oral volume, and to hospital discharge trended shorter in early vs. late group. Discontinuing NG-tube when the oral feeding competency reaches ~75% of prescribed feeding volume is safe and appropriate in low-risk premature infants.