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Feeding intolerance following ophthalmologic examination
Insights
Ophthalmologic examinations in newborns using mydriatic eye drops may increase the risk of feeding intolerance. Researchers observed increased abdominal distention and gastric issues post-examination in neonates.
Area of Science:
- Neonatal Medicine
- Ophthalmology
- Pediatric Gastroenterology
Background:
- Necrotizing enterocolitis (NEC) has been anecdotally linked to mydriatic medications used in ophthalmologic exams.
- Mydriatic agents like cyclopentolate hydrochloride and phenylephrine hydrochloride are commonly used in neonatal eye exams.
Purpose of the Study:
- To investigate the incidence of feeding difficulties in newborns before and after ophthalmologic examinations.
- To assess the potential association between mydriatic eye drops, ophthalmologic procedures, and neonatal feeding intolerance.
Main Methods:
- A comparative study of 50 newborns undergoing ophthalmologic examinations.
- Review of nursing notes to quantify feeding difficulties, including abdominal distention and gastric aspirates, within 24 hours pre- and post-examination.
- All infants received cyclopentolate hydrochloride and phenylephrine hydrochloride prior to examination.
Main Results:
- A significant increase in abdominal distention and gastric aspirates was noted in the 24-hour period following the ophthalmologic examination compared to the pre-examination period.
- One infant developed necrotizing enterocolitis (NEC) within the 24-hour post-examination period.
- Feeding intolerance was more prevalent after the examination.
Conclusions:
- Ophthalmologic examinations in neonates, particularly those involving mydriatic medications, pose a risk of feeding intolerance.
- Potential contributing factors include the known side effects of mydriatic drugs and the physical stress of the examination.
- Neonatal feeding intolerance following eye exams warrants careful monitoring and consideration of medication and procedural impacts.
Abstract:
Reports of isolated cases of necrotizing enterocolitis following administration of mydriatric medication and ophthalmologic examination prompted a comparison of the incidence of feeding difficulties 24 hours before and 24 hours after the ophthalmologic examination of 50 newborns. All infants had received cyclopentolate hydrochloride and phenylephrine hydrochloride before the examination. A critical review of the nursing notes showed more abdominal distention and gastric aspirates in the period following the examination than in the period preceding the examination. One infant developed necrotizing enterocolitis during the 24-hour postexamination period. This study demonstrates the risk of feeding intolerance following the ophthalmologic examination of neonates. These risks may be due to the known side effects of the mydriatics, to the physical stress of the examination, or to a combination of both factors.