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Metoclopramide promotes enteral feeding in preterm infants with feeding intolerance
W L Meadow1, K C Bui, E Strates
1Department of Pediatrics, University of Chicago, Ill.
Insights
Metoclopramide (Meto) improved enteral feeding tolerance in premature infants with feeding intolerance. This bowel accelerant significantly increased feeding volumes and reduced gastric residuals without adverse effects.
Area of Science:
- Neonatology
- Gastroenterology
- Pharmacology
Background:
- Premature infants often experience feeding difficulties due to immature gastrointestinal motility.
- Enteral feeding intolerance is a common challenge in neonatal intensive care units.
Purpose of the Study:
- To investigate the efficacy of metoclopramide (Meto) as a bowel accelerant in premature infants with feeding intolerance.
- To assess the impact of Meto on feeding tolerance and gastrointestinal function in this population.
Main Methods:
- A retrospective study involving 14 premature infants who failed enteral feeding at least twice.
- Metoclopramide (Meto) was administered, and feeding tolerance (volume, gastric residuals) was monitored.
- Infant outcomes, including adverse neurological and gastrointestinal events, were assessed.
Main Results:
- Metoclopramide (Meto) administration led to a significant increase in daily enteral feeding volumes tolerated by premature infants.
- Post-Meto treatment showed a marked decrease in the percentage of feedings with significant gastric residual volumes.
- No infants receiving Meto experienced extrapyramidal symptoms, hepatic dysfunction, or necrotizing enterocolitis.
Conclusions:
- Metoclopramide (Meto) may be a beneficial therapeutic option for improving enteral feeding tolerance in premature infants.
- The study suggests that enhancing peristaltic activity with Meto can overcome feeding difficulties in this vulnerable group.
- Further research is warranted to confirm the role of Meto in managing feeding intolerance in neonates.
Abstract:
We hypothesized that the feeding difficulties experienced by premature infants are related to immature peristaltic activity and that a bowel accelerant might promote feeding in prematures. We administered metoclopramide (Meto) to 14 infants admitted to the Intensive Care Nursery at The University of Chicago between January 1, 1984, and January 1, 1987. Each infant had failed enteral feeding on at least two separate occasions. At the time of initiation of Meto, the group of infants tolerated only 11.7 +/- (SEM) 3.6 cm3/kg/day enterally. Feeding tolerance improved steadily after Meto was initiated, and by 29 days the infants tolerated 134 +/- 12.6 cm3/kg/day enterally. The average slope of the post-Meto feeding regression lines was +4.21 +/- 0.94 cm3/kg/day/day, significantly greater than -0.67 +/- 0.59 cm3/kg/day/day pre-Meto. The percentage of feedings followed by significant gastric residual volumes was 33.1 +/- 4.6% pre-Meto, compared to 6.9 +/- 2.5% post-Meto. No child receiving Meto developed any extrapyramidal neurologic symptoms, worsening of hepatic function, or necrotizing enterocolitis. Meto may have a role in the treatment of premature infants with enteral feeding intolerance.