Feeding intolerance following ophthalmologic examination.

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.