Standardization of Feeding Advancement After Neonatal Gastrointestinal Surgery: Does It Improve Outcomes?

Area of Science:

• Pediatric Surgery
• Neonatal Nutrition
• Clinical Management

Background:

• Infants undergoing postabdominal intestinal surgery (PAIS) present complex clinical challenges.
• Existing feeding guidelines improve outcomes in preterm and low-birth-weight infants.
• Standardizing feeding protocols for PAIS infants is proposed as a safe approach.

Purpose of the Study:

• To evaluate the safety and efficacy of a standardized feeding guideline for infants with PAIS.
• To assess the impact of the guideline on time to full enteral nutrition and other clinical outcomes.
• To determine the compliance rate with the implemented feeding guideline.

Main Methods:

• A retrospective study identified 163 infants with PAIS, divided into pre- and post-guideline implementation groups (93 and 70 infants, respectively).
• The primary outcome measured was the time to achieve full enteral nutrition (EN).
• A propensity score-matched analysis was conducted to compare outcomes between the groups.

Main Results:

• No significant differences were observed in time to full EN, parenteral nutrition duration, or length of hospital stay between the groups.
• The post-guideline group showed significantly less severe cholestasis.
• Breast milk utilization increased in the post-guideline group, with 67% compliance to the guideline in the first two years.

Conclusions:

• A standardized feeding guideline is safe for infants with PAIS.
• The guideline standardizes care, enhances adherence to evidence-based practices, and improves clinical outcomes.
• Increased breast milk use and reduced cholestasis severity are key benefits observed.