Meconium Passage in Very‐Low‐Birth‐Weight Infants

Abstract

The timing of the first meconium stool has been considered a marker for proper gastrointestinal functioning in the term infant. There is limited information on the meconium passage patterns of very-low-birth-weight infants of less than 32 weeks' gestation. It is unknown whether feeding practices influence the timing of the first stool in these infants. We retrospectively studied 47 very-low-birth-weight infants with birth weights of 1250 g or less who were previously enrolled in a study of gastrointestinal (GI) priming. Infants whose mothers desired to breast feed (n = 7) were given GI priming with their own mother's milk. The remaining infants had been randomly assigned to receive total parenteral nutrition alone (n = 21) or GI priming with infant formula (n = 19) during the first 14 days of life. We attempted to advance all infants to full enteral nutrition by 21 days of age. There was no statistically significant difference in timing of the first stool among the three groups. The overall median age at first stool was 43 hours, and the 75th percentile was 10 days. The range was 1/2 hour to 27 days. There was no concordance between time of first stool and birth weight within the range studied. There was no concordance between time of first stool and necrotizing enterocolitis, although there was little statistical power to detect this. There was also very little concordance with feeding tolerance. Other than necrotizing enterocolitis, no significant GI disease developed in any of the infants studied.(ABSTRACT TRUNCATED AT 250 WORDS)

Saline Enemas versus Glycerin Suppositories to Promote Enteral Feeding in Premature Infants: A Pilot Randomized Controlled Trial

“…The delayed passage of meconium and its association with feeding intolerance are well-recognized in VLBW infants [15,16]. Infants at the higher end of the intensity spectrum present with meconium obstruction of prematurity [5].…”

Impact of gestational age on the clinical presentation and surgical outcome of necrotizing enterocolitis

“…6 Meetze et al 18 reported that the passage of the first stool is significantly delayed in premature infants (up to 10 days). These investigators attributed their findings to the immaturity of the GI motor system.…”

Glycerin Enemas and Suppositories in Premature Infants: A Meta-analysis

“…9 This practice is based on the observation that many premature infants experience significant delays in the passage of meconium, which is more viscous than normal stool. 10,11 Delays in meconium evacuation seem to be associated with a delay in the transition to enteral feeding. 12 If meconium evacuation could be expedited by using glycerin enemas or suppositories, this approach might lead to faster transition to enteral feeding, decreased reliance on parenteral nutrition, and better clinical outcomes.…”