Standardization of Feeding Advancement After Neonatal Gastrointestinal Surgery: Does It Improve Outcomes?

BACKGROUND

Postabdominal intestinal surgery (PAIS) infants pose many complex management issues. Utilization of feeding guidelines has been shown to improve outcomes in preterm and low-birth-weight infants. We propose that standardization of feeding for PAIS infants is safe.

METHODS

We identified 163 PAIS infants: 93 prior to and 70 after implementation of a feeding guideline. The primary outcome was time to full enteral nutrition (EN). A propensity score-matched analysis was performed.

RESULTS

The preimplementation and postimplementation PAIS infants were similar at baseline. No significant differences were seen in matched groups for time to full EN, parenteral nutrition days, or time to discharge, but cholestasis was less severe in the postimplementation group and breast milk use increased. Good compliance (67%) to daily guideline use was achieved during the initial 2 years.

CONCLUSIONS

Utilization of a feeding guideline is safe and standardizes care within an institution, improving compliance to evidence-based practices and outcomes.