Abstract
The early introduction of milk to preterm infants has many theoretical advantages. However, enteral feeding is considered by some to be contra-indicated in ventilated infants because of fear of gastro-oesophageal reflux (GOR). We have therefore investigated this practice by monitoring GOR in six very low birth weight infants, of postr-conceptional age 26-32 weeks.
Each infant was studied twice, once during ventilation and once while breathing spontaneously in headbox oxygen. All received expressed breast milk as hourly nasogastric bolus feeds at 120-180 ml/kg/day, throughout the study. A 1mm pH electrode (Synectics Medical) was positioned l-2cm above the lower oesophageal sphincter following identification of the sphincter by manometry. Resting pressures in lower oesophageal sphincter and body did not differ significantly during ventilation. Intra-oesophageal pH was monitored continuously over 24 hours and standard indices of GOR calculated:
In all patients reflux indices were less during ventilation. Feeds were well tolerated and no child suffered deterioration attributable to aspiration pneunonia.
Early enteral nutritional support for very low birth weight infants may therefore be provided without increased risk of aspiration.
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Newell, S., Booth, I., Morgan, M. et al. 49. DOES VENTILATION PRECIPITATE GASTRO-OESOPHAGEAL REFLUX IN ENTERALLY FED VERY LOW BIRTHWEIGHT BABIES?. Pediatr Res 22, 104 (1987). https://doi.org/10.1203/00006450-198707000-00070
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DOI: https://doi.org/10.1203/00006450-198707000-00070