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New Evidence Validates Infant Feeding Connector Concerns

A new study suggests that an increasingly widespread hospital tubing system could be inaccurate—a dangerous finding for infants.

Tubes deliver food, medicine and blood or other liquids to tiny patients in neonatal intensive care.  Mixing up the various tubes could lead to serious injury, even death. So in the mid-2000s, experts called for a new style of feeding tube connector to reduce tubing misconnections.  

In response, the ENFit style connector debuted in 2014.  Its “male” feeding tube connectors are only compatible with “female” syringe tubes.  While the design reduces the likelihood of tubing mix ups, it ushered in a new issue.

According to researchers, the ENFit tubing connector “significantly increases the opportunity for inaccurate dosing.”

These findings support existing concerns.  Some health professionals and patient advocates have raised issue with the product itself, citing safety and workflow problems.  Others are apprehensive that it’s being forced into use in some places, such as California. Now, there’s evidence to support the unease.

Medicine can “hide” in the area around the syringe barrel of the ENFit connector.  If this “moat” isn’t cleared properly, too much medicine can be administered. Even a small amount of excess medicine puts these tiny infants at risk of overdose or adverse drug reactions.

The ENFit design also increases potential for bacteria to colonize if residual breast milk or formula remain in the moat.  This could introduce babies to infection, which could also have dire consequences.

While peer-reviewed evidence supporting dosing concerns had been lacking, that’s no longer the case.  After completing 576 tests, researchers at UF Health affirmed dosing inaccuracy. They also commented about the usability of the ENFit connectors and adapters, stating nurses and caregivers need “extensive training” to learn “how to appropriately use” them.

The research shows: Patient safety is on the line.  The new findings support calls from the National Coalition for Infant Health and others to ensure hospitals and health care centers are fully informed about the ENFit dosing connectors before using them.