Enteral Feeding in Prostaglandin-Dependent Neonates: Is It a Safe Practice?

Abstract

In many centers presurgical term neonates with prostaglandin (PGE 1 )-dependent cardiac lesions experience nutritional deficiency due to postponed enteral feeds. We recently adopted early enteral feeding in these infants. This retrospective study reveals feeding tolerance in 33 of 34 neonates fed enterally while receiving PGE 1 , suggesting the safety of this practice.

Nutrition and growth in congenital heart disease

“…In a survey of 200 caregivers, routine preoperative feeding in prostaglandindependent infants ranged from 56% (US) to 93% (outside the US). In two separate studies, it appears that feeding prostaglandin-dependent infants is safe, with no increase in necrotizing enterocolitis [40][41][42]. While there is a general assumption that preoperative enteral nutrition may lead to improved feeding behaviors postsurgery, there was no difference in the need for nasogastric feedings at discharge between presurgical and postsurgical feeding groups [40].…”

Nutritional challenges and outcomes after surgery for congenital heart disease

“…Willis et al [27] instituted early enteral feeding in 34 hemodynamically stable preselected prostaglandin E 1 (PGE 1 )-dependent term neonates (19 of them with left ventricular obstructive lesions). Only one patient exhibited enteral feeding intolerance while receiving PGE 1 , suggesting that it may be a safe practice on stable preoperative PGE 1 -dependent term neonates.…”

Enteral Feeding of Neonates with Congenital Heart Disease

“…Ensuring adequate enteral nutrition in these infants prior to surgery is fraught with difficulties: they may be at risk for systemic hypoperfusion and necrotizing enterocolitis (NEC), often feed poorly and may be hemodynamically unstable [2,3] . In addition, many clinicians may not provide enteral feeds while administering prostaglandins, although with scant evidence of the safety or risk of the practice [4] . Surgical repair of congenital heart defects, typically during the first few weeks of life may involve cardiopulmonary bypass and deep hypothermic circulatory arrest.…”