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Enteral refeeding is useful for promoting growth in neonates with enterostomy before stoma closure
Yuhki Koike1, Keiichi Uchida1, Yuka Nagano1
1Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Mie, Japan.
Insights
Enteral refeeding (ER) significantly improves weight gain in neonates after enterostomy. This nutritional support is particularly beneficial for low-birth-weight infants, accelerating their growth.
Area of Science:
- Neonatal surgery
- Pediatric nutrition
- Gastroenterology
Background:
- Enterostomy in neonates can cause fluid/electrolyte imbalance and impaired nutritional absorption, hindering growth.
- Enteral refeeding (ER) is a potential intervention to mitigate these complications.
Purpose of the Study:
- To evaluate the effectiveness of enteral refeeding (ER) in premature and full-term neonates following enterostomy.
- To assess the impact of ER on neonatal growth and weight gain.
Main Methods:
- Retrospective analysis of neonates undergoing enterostomy between 2000-2014.
- Comparison of 13 patients receiving ER (ER group) versus 14 patients not receiving ER (control group).
- Evaluation of clinical data, focusing on body weight increment during ER.
Main Results:
- The ER group demonstrated a significantly higher rate of weight gain compared to the control group (P=0.0012).
- ER showed benefits across different gestational ages and was associated with greater weight gain when initiated at lower body weights (P=0.0002).
- ER procedure (P<0.0001) and birth weight (P=0.049) were independent predictors of improved weight gain.
Conclusions:
- Enteral refeeding (ER) offers significant benefits for neonatal growth acceleration, especially in low-birth-weight infants.
- ER is recommended for neonates, including those with low birth weight or low body weight at the start of feeding.
Background:
Enterostomy may lead to fluid and electrolyte imbalance, or impaired absorption of nutrition followed by impairment of growth. This study aimed to clarify the effectiveness of enteral refeeding (ER) in premature and full-term neonates.
Methods:
A retrospective database of all consecutive neonates who had enterostomy during 2000-2014 in a regional center was analyzed. Thirteen patients with ER (ER group) and 14 patients without ER (control group) were included. Detailed clinical data were evaluated with reference to the increment in body weight during ER.
Results:
The ER group had a significantly higher rate in weight gain compared with the control group (P=0.0012), despite the gestational age (<37weeks: P=0.0012, ≥37weeks: P=0.029). ER starting at a lower body weight was also associated with a higher weight gain (P=0.0002). Moreover, univariate and multivariate analyses showed that only the ER procedure (P<0.0001) and birth weight (P=0.049) were significantly independent predictors of good weight gain.
Conclusions:
Using ER, low-birth-weight infants may have benefits, such as better acceleration of growth, than normal-birth-weight infants. We do not hesitate to perform ER, even in low-birth-weight neonates or those with low body weight, when starting ER.
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