Neonatal Feeding Intolerance In Clinical Studies

Objective The efficacy of neonatal feeding with enteral nutrition and parenteral nutrition, the compact of neonatal feeding intolerance on nutrition, the incidence of neonatal feeding intolerance, and the risk factors associated with neonatal feeding intolerance were investigated.Methods The subjects were 381 infants whom were admitted between January 2003 to November 2003. The criteria of neonatal feeding intolerance made by Huangying was used, such as vomiting≥3 times daily, enteral feeding didn't increase or decrease >3 days, gastric residual volume > 1/3 of a given amount of feeding were adoped.381 cases infants were divided into feeding intolerance group (FI group) and non-feeding intolerance group (non-FI group). Feeding intolerance group was given erythromycin intravenously at a dose of 3-5mg/kg, one to two times daily for 5-7 days and >7days in some cases. The clinical data clue such as daily feeding volume, weight and daily calorie intake were recorded. Comparison was made between two groups about feeding efficacy, the risk factors associated with neonatal feeding intolerance was analyzed, the incidence of neonatal feeding intolerance was recorded. Result (1) The incidence of term infant and preterm infant BW>2500g,BW2001~2500g,BW≤2000 g was 9.7%,25%,50%,73.7% ,respectively, Statistical difference is significant,χ2=92.205,p<0.01. (2) Compared with the non-feeding intolerance group, term infants and different birth weight preterm infants with feeding intolerance, the time of daily calorie intake reach 80Kcal/kg per day (334.4KJ/kg per day)and regain birth weight was markedly delayed. But the gestational age,birth weight and the day calorie intake reach 40Kcal/kg per day(167.2KJ/kg per day),calorie enteral intake reach 80Kcal/kg per day (334.4KJ/kg per day)and reach full enteral feeding were not significant different in two groups. (3) The risk factors associated with feeding intolerance were low birth weight (p<0.01), fetal hypoxia (p<0.05), and gastric hemorrhage (p <0.01). (4) The time which reaching full enteral feeding was markedly delayed in the gastric hemorrhage group compared with the non-gastric hemorrhage group among feeding intolerance infants (17.63±7.97 vs 12.29±5.34days,t= -2.121,p<0.05). But the time of regaining birth weight was not significant different between two groups(10.75±5.04 vs 8.4±3.42 days,t= -1.729,p>0.05).Conclusion The incidence of neonatal feeding intolerance in term infant, preterm infant BW >2500g,BW2001-2500g,BW≤2000 g is 9.7%,25%,50%,73.7%, respectively. The criteria of neonatal feeding intolerance on neonatal nutrition were analyzed. We considered that daily calorie intake reaching 80Kcal/kg per day (334.4KJ/kg per day)and regain birth weight could be used as a mark as the nutrition of feeding intolerance. The significant risk factors associated with feeding intolerance are low birth weight, fetal hypoxia, gastric hemorrhage. Parenteral nutrition combined with correct feeding scheme could offer enough calorie to meet growth and transit to enteral feeding in the end.