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Bowel habits in preterm infants: Observations from the first 2 weeks of life
Ulrikke Lyng Beauchamp1, Susanne Soendergaard Kappel1, Ilan Jasper Nader Koppen2
1Department of Neonatology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Insights
This study describes preterm infant bowel habits in the first two weeks of life, finding no link to prenatal events. Standardized tools are recommended for future research on infant gastrointestinal health.
Area of Science:
- Neonatalogy
- Pediatric Gastroenterology
- Infant Health
Background:
- Lack of uniform descriptions for normal preterm infant bowel habits creates diagnostic ambiguity.
- Understanding typical bowel patterns is crucial for identifying abnormalities in this vulnerable population.
Purpose of the Study:
- To examine the bowel habits of preterm infants during the first two weeks of life.
- To investigate associations between infant bowel habits and maternal/infant factors.
- To establish a baseline for normal bowel function in preterm neonates.
Main Methods:
- Observational study of infants with gestational age < 31 weeks.
- Data collected from medical records: prenatal events, bowel habits, feeding, and laxative use.
- Infants categorized as extremely preterm (EPI, GA < 28 weeks) or very preterm (VPI, GA ≥ 28 weeks).
Main Results:
- EPI received initial enteral feeds later than VPI (median 5h vs 2h).
- No significant difference in first meconium passage time between EPI and VPI.
- Saline enemas used in 21% of infants; laxatives initiated before 2 weeks in 41% of EPIs.
Conclusions:
- The study provides a detailed day-by-day account of bowel habits, feeding, and laxative use in preterm infants.
- No associations were found between prenatal events and infant bowel habits.
- Recommends standardized observation tools for consistent research and comparison across studies.
Objectives:
Uniform descriptions of normal preterm infant bowel habits are lacking, causing ambiguity in identifying abnormal bowel habits in this population. This study examines preterm infants' bowel habits and their association with maternal and infant factors in the first 2 weeks of life.
Methods:
An observational study included infants with a gestational age (GA) < 31 weeks from January to September 2021. From infant and maternal medical records, information on prenatal events, 2 weeks of bowel habit observations, enteral feeding, and laxative treatment was obtained. Extremely preterm infants (EPI) and very preterm infants (VPIs) were defined as GA < 28 weeks and GA ≥ 28 weeks, respectively.
Results:
Of the 93 infants, 53 (57%) were included, and 37 (70%) were EPI. EPI received first enteral feeds at a median of 5 h after birth versus 2 h after birth in VPI (p < 0.01). EPI passed their first meconium at a median of 30 h (interquartile range [IQR] 12-49 h) after birth versus 26 h in VPI (IQR: 10-40, p = 0.2). In 21% of all infants, saline enemas were used to induce the passage of meconium. In 41% of EPIs (n = 15) laxatives were initiated before 2 weeks of age. Stool frequency varied from 0 to 9 stools daily, and prenatal events did not affect bowel habits.
Conclusion:
This study provides a day-by-day description of bowel habits, enteral feeds, and laxative treatment but shows no associations with prenatal events in preterm infants. For future research, we recommend implementing homogeneous observation tools to enable comparison between studies.
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