Use of Breast Milk and Other Feeding Practices following Gastrointestinal Surgery in Infants

Sanskriti Varma, Edward L. Bartlett, Lucy Nam, Darla R. Shores

Research output: Contribution to journalArticle

Abstract

Objectives:The aim of the study was to characterize the enteral feeding practices in infants after gastrointestinal surgery.Methods:We performed a retrospective analysis of infants who underwent intestinal surgery at age <6 months who survived to be fed enterally between January 2012 and June 2017. Demographics, surgical characteristics, feeding practices, and growth-related outcomes during hospitalization, discharge, and follow-up (3, 6, and 12 months) were obtained from the electronic medical records. Descriptive statistics compared infants by their initial diagnosis.Results:We reviewed 111 infants: Necrotizing enterocolitis (NEC) = 21, gastroschisis = 28, atresia = 27, spontaneous intestinal perforation (SIP) = 18, and other diagnoses = 17. Most infants (77%) received mother's milk (MM) as the first postoperative feed, but this differed by diagnosis (P = 0.004). Donor milk was used in 11%, most commonly in infants with NEC and SIP. Infants with NEC were least likely to continue MM in the hospital (7%, P = 0.0014) and were more likely to receive elemental formula. Only 44% of infants received MM at discharge. After 1 year, 25% were fed MM. The majority of infants were discharged with feeding tubes (nasogastric: 35%, gastric: 23%). Although all groups had acceptable weights at discharge, infants with NEC (z score:-1.8) and SIP (z score:-1.1) showed growth failure at 3 months (z scores:-3.3,-3.2, respectively, P < 0.0001), but had appropriate gain by 1 year (z scores:-1.1,-1.7, respectively).Conclusions:Despite most infants receiving MM in the early postoperative period, <50% at discharge and only 33% at 1-year still received MM. Weight gain after discharge in infants with NEC and SIP warrants close monitoring.

Original languageEnglish (US)
Pages (from-to)264-271
Number of pages8
JournalJournal of pediatric gastroenterology and nutrition
Volume68
Issue number2
DOIs
StatePublished - Jan 1 2019

Keywords

  • enteral nutrition
  • intestinal surgery
  • necrotizing enterocolitis
  • spontaneous intestinal perforation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Gastroenterology

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