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Paeds Casesfetal-neonatal-and-perinatal

Paeds Cases · fetal-neonatal-and-perinatal

Poor feeding and feeding intolerance in the neonate — case

Long case and communication station.

long case with communication3 min readVerification in progress

Target exams

RACP DCEMRCPCH Clinical
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Study tools

Target exams

RACP DCEMRCPCH Clinical
Prompt
A preterm neonate with feeding intolerance progressing to necrotising enterocolitis, and a concerned family.

Case summary

A 12-day-old infant born at 27 weeks' gestation, weighing 920 g, is on the neonatal unit on advancing expressed breast milk feeds at 120 mL/kg/day. Over the shift, the pre-feed gastric residual has risen to exceed the feed volume and is bile-stained, the abdomen has become fuller, and the infant has had three apnoeic spells requiring stimulation. The nursing staff are concerned. [1] [2]

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References5ShowHide
  1. [1]Walsh MC, Kliegman RM Necrotizing enterocolitis: treatment based on staging criteria. Pediatric Clinics of North America, 1986.PMID 3081865
  2. [2]Neu J, Walker WA Necrotizing enterocolitis. New England Journal of Medicine, 2011.PMID 21247316
  3. [3]Quigley M, Embleton ND Formula versus donor breast milk for feeding preterm or low birth weight infants. Cochrane Database of Systematic Reviews, 2019.PMID 31322731
  4. [4]Oddie SJ, Young L Slow advancement of enteral feed volumes to prevent necrotising enterocolitis in very low birth weight infants. Cochrane Database of Systematic Reviews, 2021.PMID 34427330
  5. [5]Fanaroff AA, Korones SB Incidence, presenting features, risk factors and significance of late onset septicemia in very low birth weight infants. The National Institute of Child Health and Human Development Neonatal Research Network. Pediatric Infectious Disease Journal, 1998.PMID 9686724
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