Related Experiment Video
Updated: Jun 14, 2025
Probiotic Studies in Neonatal Mice Using Gavage
Published on: January 27, 2019
Evaluation of gastroschisis feeding protocol: A retrospective cohort study
Jeewan Jyoti1, Kristen James-Nunez1, Kaye Spence1,2
1Grace Centre for Newborn Intensive Care, The Children's Hospital of Westmead, Sydney, New South Wales, Australia.
Insights
A new feeding protocol for infants with gastroschisis significantly speeds up the start of enteral and suck feeds. This standardized approach also reduces the length of hospital stays and the need for total parenteral nutrition (TPN).
Area of Science:
- Neonatal care
- Pediatric surgery
- Clinical nutrition
Background:
- Infants with gastroschisis often face challenges with feeding due to gastrointestinal malformations.
- Early and appropriate nutrition is crucial for the growth and development of these vulnerable infants.
- Standardized feeding protocols can potentially optimize nutritional management and improve clinical outcomes.
Purpose of the Study:
- To assess the impact of a standardized feeding protocol on early enteral and suck feeds in infants with gastroschisis.
- To evaluate secondary outcomes including growth, length of stay, total parenteral nutrition (TPN) duration, sepsis, and bilirubin levels.
- To compare outcomes between infants managed before and after the implementation of the feeding protocol.
Main Methods:
- A single-centre retrospective quality improvement project was conducted.
- Infants with gastroschisis admitted between 2010 and 2021 were included.
- Outcomes were compared between a pre-feeding protocol group and a post-feeding protocol group.
Main Results:
- The post-feeding protocol group showed a significant reduction in the time to first enteral feed (P<0.0001) and first suck feed (P=0.002).
- Median length of stay in the neonatal intensive care unit (NICU) was significantly shorter by 11 days in the post-protocol group (P=0.001).
- The duration of TPN was significantly longer in the pre-feeding protocol group (241 hours, P=0.0007).
Conclusions:
- Implementation of a standardized feeding protocol for gastroschisis accelerates the initiation of enteral and suck feeds.
- The protocol is associated with a reduced duration of NICU admission and potentially less reliance on TPN.
- This quality improvement initiative demonstrates the benefits of standardized feeding pathways in neonatal surgical care.
Aim:
The primary objective of this study is to determine the impact of a standardised feeding protocol for infants with gastroschisis on early enteral feeds, suck feeds, management of gastric residuals and breastfeeding at discharge. Secondary objectives were evaluation of growth, length of stay in neonatal intensive care unit (NICU), the duration of total parental nutrition (TPN), blood-culture confirmed sepsis and serum bilirubin level (SBR).
Methods:
This single-centre retrospective quality improvement project included infants admitted to a quaternary care NICU for management of gastroschisis from 2010 to 2021. The Gastroschisis feeding protocol, a standardised pathway for managing the feeding of infants with gastroschisis, was implemented in this NICU in 2016. The outcomes of infants in the pre-feeding protocol and post-feeding protocol groups were compared.
Results:
Of the 100 infants included in the study, 49 were in the post-feeding protocol group. The baseline characteristics of the study population did not differ statistically in both groups. In post-feeding protocol group, there was significant reduction in the time to the first enteral feed (P value <0.0001) and first suck feed (P value = 0.002). The median length of stay in the post-feeding protocol group was significantly lower by 11 days (P value = 0.001). Duration of TPN was 241 h higher in the pre-feeding protocol group (P value 0.0007).
Conclusions:
Implementation of a feeding protocol in infants with gastroschisis led to earlier initiation of enteral feeds and suck feeds. There is a likelihood of reduction in the use of TPN and duration of admission in NICU.
