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Updated: Aug 31, 2025

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Management of prolonged meconium evacuation in preterm infants: A survey-based analysis in German Neonatal Intensive

Matthias Lange1, Yannick Figura1, Carolin Böhne2

  • 1Department of Pediatrics, Elisabeth Children's Hospital, University of Oldenburg, Oldenburg, Germany.

Acta Paediatrica (Oslo, Norway : 1992)
|August 25, 2022
PubMed

Insights

Delayed meconium evacuation in preterm infants is common. Rectal enemas within 48 hours significantly reduced FIP incidence, though treatments varied widely across German NICUs.

Area of Science:

  • Neonatalogy
  • Pediatric Gastroenterology
  • Clinical Pharmacy

Background:

  • Preterm infants often experience delayed meconium passage due to immature bowel motility.
  • Rectal enemas and oral laxatives are common interventions for these bowel evacuation disorders.

Purpose of the Study:

  • To investigate current practices for managing delayed meconium evacuation in German Neonatal Intensive Care Units (NICUs).
  • To assess the utilization of rectal enemas and oral laxatives and their outcomes.

Main Methods:

  • An online survey was distributed to 163 high-level NICUs in Germany.
  • Participants were queried about rectal enema use, laxative therapy, and outcome incidences.

Main Results:

  • 67.5% of NICUs participated, with 93.6% using rectal enemas for delayed meconium evacuation.
  • 57.3% also used oral laxatives, employing diverse solutions and application systems.
  • Early enema administration (within 48 hours) was linked to a significantly lower incidence of Fecal Impaction (FIP).

Conclusions:

  • Therapeutic approaches for prolonged meconium evacuation vary significantly among German NICUs.
  • A wide diversity in applied substances, administration methods, and intervention frequency was observed.
  • Macrogol was frequently used as an oral laxative in neonates, despite lacking manufacturer approval.
Abstract

Keywords:
meconium evacuationoral laxativespreterm infants

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