Prediction Of Feeding Difficulties In Post-Operative Neonates

PREDICTION OF FEEDING DIFFICULTIES IN NEONATES Alexandra R. Adler, B. Joyce Simpson, Karen A. Diefenbach, and Richard A. Ehrenkranz. Section of Pediatric Surgery, Department of Surgery, Yale University, School of Medicine, New Haven, CT and Section of Pediatric Surgery, Nationwide Children’s Hospital, Columbus, OH. The purpose of this study was to determine whether feeding difficulties in post-operative neonates correlate with intraoperative findings. A retrospective study of neonates undergoing gastrointestinal surgery between January 2002 and December 2005 was performed. Operative notes were used to classify infants into four groups based on post-operative anatomy and anticipated intestinal function: class 1: anatomically normal/normal function (n=22); class 2: anatomically normal/dysfunction (n=21); class 3: anatomically short/normal function (n=31); and class 4: anatomically short/dysfunction (n=21). Class 3 was further divided into two subgroups based on ostomy location: proximal ostomy (class 3a, n=11) vs. distal ileostomy (class 3b, n=21). Anatomically short was defined as loss of >50% of small bowel or high ostomy. Dysfunction was defined as decreased motility or absorptive capacity of the small bowel due to dilation, inflammation, or ischemia. Data were collected from the first day of enteral feeding until the infant reached full feeds or was discharged. Outcomes included: time to 50% and to full enteral feeds, days on TPN/lipids, and episodes of feeding intolerance (large aspirates, emesis) or malabsorption (increased volume or watery consistency of stools). Statistical analyses were performed using Kruskal–Wallis test for continuous variables and chi-square test for dichotomous variables.