LESSON PLAN ON WATI-

SPOON/PALADAI
FEEDING

Subject: Child Health Nursing

Topic: Wati-spoon feeding/Paladai

Unit: 3rd Year Bsc Nursing

Venue: Simulation lab

Date: 09/03/2021

Name of the Student:

Name of the Guide:

Class to be taught: 3rd Year BSc Nursing Students

Method of Teaching: Discussion and Demonstration

Previous Knowledge of the group: Students have some clinical knowledge on spoon
feeding.

General Objective: At the end of the practice teaching the group will be able to understand
and practice Wati-spoon/paladai feeding.

Specific Objective: At the end of the practice teaching, students will be able to

1. Define Wati-spoon Feeding/Paladai Feeding

2. Enlist the purpose of wati-spoon feeding
3. Enlist the advantages and dis advantages
 4. To demonstrate the procedure

Sr. Time Specific Content Teacher/Learner’s Activity Audio- Evaluatio

No Learning visual n
Objectives Aid
1 2 At the end Introdu The teacher will introduce Flash At the
mins of the ction herself and greet the students. cards/D end of
practice iscussio the
teaching, Students greet back. n practice
2nd year Teacher will introduce her topic teaching
students i.e, Wati-spoon /Paladai feeding the
will be students
able to The teacher will ask the students will be
whether they have seen any able to
babies fed with wati -spoon answer
/paladai
Students replies yes.
2 2 min Define Definiti Teacher: Can you tell me what Domen At the
wati- on do you know about wati- stration end of
spoon spoon /paladai feeding? the
/paladai practice
feeding Students: it is used to feed teaching
babies the
students
Teacher: yes, Wati-spoon will be
Feeding is used to feed babies able to
who are having difficulty in answer
sucking milk from mother’s
breast.
3 2min Enlist the Indicati Teacher continues by saying the Flash What are
indications on indications for wati -spoon cards the
for wati- feeding. Indicatio
spoon Wati-spoon feeding is given for: ns for
feeding  Small for gestational age Wati-
infants spoon
  Premature babies who Feeding?
have good swallowing
reflex but poor sucking
reflex.
 Low birth weight babies
4 5 min Enlist the Contra- Teacher asks the students Flash What are
Contra- indicati -whether we can give wati cards the
indications ons -spoon feeding for all babies? contra-
Students: remain quiet indicatio
Teacher continues by explaining ns for
that wati-spoon feeding can’t be Wati-
given for all babies. Later she spoon
explains the contra-indications, Feeding?
which follows as:
 Congenital anomalies
-cleft lip or cleft palate
 Extremely low birth
weight below 1000 gm
 Absence of
sucking/swallowing
reflex
 Semi-
conscious/unconscious
babies
 Ventilated babies
5 5min Explain Purpose Teacher continues by explaining Pictures How to
the the purpose of wati-spoon /explan feed a
purpose feeding. ation baby
PURPOSE with
-To feed babies with poor wati-
sucking reflex such as those with spoon
birth asphyxia, sepsis, cleft feeding?
palate
-Sick mother, caesarean section,
 breast abscess etc. till mother is
ready to feed.
6 5 min Explains Article Teacher will gather equipment Demon What are
the Prepara for Wati-spoon/Paladai feeding stration the
equipment tion A Sterile Tray containing: / articles
’s needed  Sterile steel bowl /Katori display needed
(medium sized) for wati
 Steel teaspoon /Paladai -spoon
 Disposable paper towel feeding?

 Clean face towel

 Measuring cup
 Luke warm water
7 5 min Explains Pre- Teacher continued by explaining Lecture
the Pre- procedu manual method for expression of cum What are
Procedure ral milk, discussi the pre-
Preparatio Prepara Sterilization of Articles and on procedur
ns tion Preparation of Formula feed. al
PREPARATION OF THE preparati
BABY on
 Explain mother about the needed?
need to feed the baby
with spoon or paladai
 Assist the mother in
expressing Breast milk
 Check for physician’s
order for feeding amount,
frequency.
 Let the mother sit with
the baby

8 20 Explains Proced Teacher had arranged all the Display How to

mins Procedure ure articles. Done handwashing. /Demon feed a
Assessed the vital signs of the stration baby
baby. Perform hand hygiene. with
Position the baby in sitting wati-
position. spoon
feeding?
Then she explained that if the
baby is fed by the nurse:

-Position the baby in sitting

position with the help of non-
dominant hand across the back
of neck, keeping paper towel
folded in front or use a bib.

-Check the temperature of the

milk.

Measure required amount of

feed into paladai.

-Place the spike of the paladai at

the corner of the baby’s mouth
and milk is allowed to flow
slowly with minimum spillage.

-Feed the baby slowly

-Burp in between.

-After finishing the feed, burp

the baby and place in side lying
position.

If fed by the mother

-Assist mother to hold baby in

lap or in baby bed as
comfortable for her.

- same steps to be followed for

paladai feeding.
 -If katori- spoon, measure the
amount and pour in katori, assist
to feed with spoon.

Baby should be actively

swallowing.

Repeat the process until desired

amount fed.

Frequently burp the baby, after

completion of the feeds, baby
had to be kept in side lying
position.

Document the findings.

9 5 min Post- Post Remove the articles from the Discuss What rae
procedure procedu baby’s surrounding. ion the post-
care re care Wipe the face and mouth with procedur
disposable paper towel or face e care
towel.
Burp the baby.
Position the baby in side lying
/lateral position.
Observe for any complications -
vomiting, abdominal distension
Documentation
10 5 Enlist the ADVANTAGES What are
minut Advantage This mode of feeding is a bridge the
es s and between gavage feeding and advantag
Disadvant breast feeding es and
ages Chances of transmission ids
associated with feeding is less advantag
when compared to bottle feeding es of
Best method for stable wati-
 premature and low birth weight spoon
babies. feeding?

DISADVANTAGES
Cannot replace direct
breastfeeding advantages
Delay in the development of
sucking reflex
Poor bonding with mother and
child

RECAPITUALIZATION

Today we have learned about what Wati-spoon /Paladai feeding, its purpose, Indications and
the procedure, the important points to be kept in mind before feeding the baby with
wati/spoon feeding. Extra precaution should be taken while feeding newborn, burp the baby
frequently, position the baby to prevent aspiration. Watch for any sudden changes in vital
signs. Watch for desaturation /abdominal distension, respiratory distress.

CONCLUSION

Babies are very sensitive. Even a small carelessness may harm the babies/puts their life in
danger. Being a NICU nurses, it is very important to take care of the feeding procedures
carefully to prevent aspiration and further complications.

ASSIGNMENTS

1. Define Wati-spoon Feeding?

2. Enlist the purpose and Indications for wati-spoon Feeding?
3. What are the nursing responsibilities in feeding a low-birth-weight baby with wati-
spoon/paladai?

BIBLIOGRAPHY

 Wong’s (2017), Essentials of Pediatric Nursing.

  Lippincott, Manual of nursing practice, eighth edition, Philadelphia,
 Parul Dutta, Paediatric Nursing, Second Edition , Jaypee brothers publication,

CONTENT

KATORI-SPPON FEEDING OR PALADAI FEEDING

INTRODUCTION

Feeding in a normal newborn is natural when we think about breast feeding where the feed is
ready at birth.

But in some cases, where the baby is unable to feed directly on the breast can be fed with
expressed breast milk with a katori and spoon or paladai

INDICATION

 Small for gestational age infants

 Premature babies who have good swallowing reflex but poor sucking reflex.
 Low birth weight babies

CONTRA-INDICATION

 Congenital anomalies -cleft lip or cleft palate

 Extremely low birth weight below 1000 gm
 Absence of sucking/swallowing reflex
 Semi-conscious/unconscious babies
 Ventilated babies

PURPOSE

 To feed babies with poor sucking reflex such as those with birth asphyxia, sepsis, cleft
palate
  Sick mother, caesarean section, breast abscess etc. till mother is ready to feed.

PREPARATION OF ARTICLES

A Sterile Tray containing:

 Sterile steel bowl /Katori (medium sized)

 Steel teaspoon /Paladai
 Disposable paper towel
 Clean face towel
 Measuring cup
 Luke warm water

PREPARATION OF THE BABY

 Explain mother about the need to feed the baby with spoon or paladai
 Assist the mother in expressing Breast milk
 Check for physician’s order for feeding amount, frequency.
 Let the mother sit with the baby

PROCEDURE

Sr. Nursing Action Rationale

No.
1. Arrange all articles near the baby unit To perform the procedure smoothly.
2. Assess the vital signs of the baby. To make sure the baby is ready for
taking oral feeds.
3. Perform hand hygiene To maintain sterility
4. IF fed by the nurse:

-Position the baby in sitting position with

the help of non-dominant hand across the
back of neck, keeping paper towel folded in
 front or use a bib.

-Check the temperature of the milk

-Measure required amount of feed into

paladai.

-Place the spike of the paladai at the corner

of the baby’s mouth and milk is allowed to
flow slowly with minimum spillage.

-Feed the baby slowly

-Burp in between.

-After finishing the feed, burp the baby and

place in side lying position.
5. If fed by the mother To build confidence in the mother
on how to feed the baby
-Assist mother to hold baby in lap or in baby
bed as comfortable for her.

- same steps to be followed for paladai

feeding

-If katori- spoon, measure the amount and

pour in katori, assist to feed with spoon.
6. Baby should be actively swallowing To prevent the risk of aspiration
7. Repeat the process until desired amount fed To meet the nutritional requirement
of the baby.
8. If any vomiting occurs, stop, burp the baby To prevent aspiration and other
and report to physician. complications.
9. Documentation To record the procedure, the amount
and frequency of feeds.
POST PROCEDURE CARE

 Remove the articles from the baby surrounding

 Wipe the face and mouth with disposable paper towel or face towel
 Burp the baby
 Position the baby in side lying /lateral position.
 Observe for any complications - vomiting, abdominal distension
 Documentation

ADVANTAGES

 This mode of feeding is a bridge between gavage feeding and breast feeding
 Chances of transmission associated with feeding is less when compared to bottle
feeding
 Best method for stable premature and low birth weight babies.

DISADVANTAGES

 Cannot replace direct breastfeeding advantages

 Delay in the development of sucking reflex
 Poor bonding with mother and child