Enteral Feeding in Neonatal Hypoxic-Ischemic Encephalopathy

Area of Science:

• Neonatology
• Pediatric Gastroenterology
• Neurology

Background:

• Hypoxic-ischemic encephalopathy (HIE) is a serious birth complication affecting neonates.
• Impaired oral feeding is a common challenge in infants with HIE.
• Feeding outcomes vary significantly based on the method of nutritional support at discharge.

Purpose of the Study:

• To describe feeding outcomes in neonates with HIE.
• To compare characteristics and outcomes of neonates discharged on oral, nasogastric, or gastrostomy tube feedings.
• To identify factors associated with different feeding modalities at discharge.

Main Methods:

• Retrospective, single-center cohort study of infants with moderate or severe HIE.
• Cooling therapy administered from January 2017 to June 2022.
• Data collected on hospital course and 6-month follow-up; statistical analysis included chi-square and ANOVA.

Main Results:

• Of 123 infants, 77% were discharged on oral feeds, 9% on nasogastric, and 14% on gastrostomy tubes.
• Gastrostomy tube group had more intrapartum complications, lower Apgar scores, severe HIE, seizures, longer hospital stays, and delayed feeding initiation.
• Infants on nasogastric feeds achieved oral feeding within a median of 54 days; gastrostomy group had lower weight and head circumference percentiles.

Conclusions:

• Earlier identification for gastrostomy tube insertion and discharge on nasogastric feeds may reduce hospitalization duration.
• Antepartum complications and HIE severity are linked to gastrostomy tube use.
• These findings can inform practice improvements for enteral feeding in HIE neonates.