Nasojejunal feedings are frequently advocated for ill preterm infants on the basis of lower esophageal sphincter (LES) in competence. We previously evaluated LES pressures in healthy term infants and found them to be indicative of sphincter competence. We have now measured LES pressures in 7 ill preterm infants receiving respiratory assistance. Pressure recordings were obtained using a single lumen side opening perfused catheter, and compared with pressures from healthy term and preterm infants (see table). The groups differed in gestational age (GA), and postnatal age (PA) but LES pressures were unaffected by these two variables. Even the smallest infant studied (720gm, pH 7.20) exhibited normal LES pressure (40 mmHg). Subsequent to studies, all infants were fed by continuous drip gastric lavage without any clinical evidence of regurgitation or aspiration.
Our data indicates that the LES is competent at an early developmental age. The use of nasojejunal instead of nasogastric feedings can not be justified on the basis of suspected LES incompetence.
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Antonson, D., Vanderhoof, J. & Paxson, C. 391 LOWER ESOPHAGEAL SPHINCTER PRESSURE IN ILL PRETERM INFANTS. Pediatr Res 12, 429 (1978) doi:10.1203/00006450-197804001-00396