Use of metoclopramide in preterm infants

6 preterm infants with birth weights ranging from 790 to 1,040 g and gestational ages of 26-35 weeks were given metoclopramide at a mean postnatal age of 35 days. The infants were selected only after fulfilling rigid clinical criteria. All infants were spontaneously breathing and were on parenteral nutrition with 3% Vamin and 10% Neutralipid. Metoclopramide, 0.1 mg/kg/day, was given intravenously in three divided doses. Progress was monitored using abdominal girth, gastric residual aspirate before each feed, intestinal transit times, daily weight gain, number of episodes of vomiting or regurgitation and assessment of tolerance to increasing amounts of feeds. Excellent response was seen in all infants. Withdrawal of the drug led to prompt recurrence of all symptoms and signs which again disappeared on reinstitution of the medication. No untoward side-effects were noted during the administration of the drug. We conclude that, in selected cases, metoclopramide may be used for persistent functional feeding intolerance and gastric stasis.