NPO: When Your Baby Cannot Receive Feedings Temporarily
What Does NPO Mean?
NPO stands for nil per os, a Latin phrase meaning "nothing by mouth."
In the NICU, NPO generally means your baby is temporarily not receiving breast milk or formula by mouth or through a feeding tube.
Your baby may still receive fluids and nutrition through an IV during this time.
Why Might My Baby Be NPO?
There are several reasons why the NICU team may temporarily stop feedings.
These may include:
Feeding intolerance: Your baby may be having difficulty tolerating feedings.
Abdominal concerns: The team may need to evaluate symptoms such as abdominal distention, vomiting, or changes in bowel function.
Medical procedures or surgery: Feedings may need to be held before certain procedures.
Concern for infection or illness: Some medical conditions require temporarily resting the gastrointestinal tract.
Necrotizing Enterocolitis (NEC): If NEC is suspected or diagnosed, feedings are typically stopped while your baby receives evaluation and treatment.
Not every baby who is made NPO has a serious medical condition. Sometimes feedings are held as a precaution while the care team evaluates a concern.
How Will My Baby Receive Nutrition?
If your baby cannot receive milk for a period of time, the NICU team will determine how to provide appropriate hydration and nutrition.
Depending on how long feedings are expected to be held, your baby may receive:
IV fluids: Provide hydration and glucose.
TPN (Total Parenteral Nutrition): Provides nutrients such as glucose, amino acids, vitamins, and minerals through an IV.
IV lipids: Provide essential fats and additional calories.
Not every baby who is NPO will need TPN. The type of support depends on your baby's medical condition and anticipated nutritional needs.
When Can My Baby Start Feeding Again?
The decision to restart feedings depends on why your baby was made NPO.
The NICU team may consider:
Improvement in symptoms
Abdominal examination findings
Laboratory or imaging results, when indicated
Overall medical stability
Some babies restart feedings relatively quickly, while others need a longer period without enteral nutrition.
Feedings may be restarted gradually so the team can monitor your baby's tolerance.
What Can Parents Do?
Having feedings stopped can feel discouraging, especially when your baby has been making progress.
You can ask your baby's care team:
Why are feedings being held?
What are we watching for before restarting?
How is my baby receiving nutrition right now?
Should I continue pumping and storing breast milk?
If you are providing breast milk, continuing to pump may help maintain your milk supply until your baby can resume feedings.
What Should Parents Know?
Being NPO does not necessarily mean your baby has lost feeding progress.
Sometimes temporarily holding feedings is an important part of evaluating or treating a medical concern.
Your baby's NICU team will work toward restarting feedings when it is medically appropriate.
