Affiliations: [a] Department of Surgery, The Icahn School of Medicine Mount Sinai, New York, NY, USA
| [b] The Icahn School of Medicine Mount Sinai. New York, NY, USA
| [c] Division of Pediatric Surgery, Department of Surgery, The Icahn School of Medicine Mount Sinai, New York, NY, USA
Address for correspondence: Brian A. Coakley, MD, FACS, FAAP, 5 E 98th St, 15th Fl, New York, NY 10029. Tel.: +1(212) 241 1602; Fax: +1(212) 241 7188; E-mail: [email protected].
Abstract: BACKGROUND:Necrotizing enterocolitis (NEC) is a serious, often fatal, disease of neonates. Minimal data exists regarding the optimal method for reintroducing feeds after successful treatment. This study aims to compare outcomes in patients reintroduced to bolus or continuous feeds after treatment for medical NEC. METHODS:A retrospective review of infants treated for medical NEC in the neonatal intensive care unit (NICU) from 2011-2018 was performed. Demographics, information about initial feeds, clinical diagnosis data, and information about reintroduction of feeds were recorded. Patients with significant congenital heart disease or those who required procedures for treatment were excluded. RESULTS:Sixty-one patients were analyzed; 45 were reintroduced to bolus feeds and 16 to continuous feeds. There were no differences between the two groups. Bolus-fed patients reached goal feeds quicker (p = 0.007), required fewer days of parenteral nutrition (p = 0.002), had shorter hospital stays (p = 0.013) and were discharged faster from diagnosis to discharge (p = 0.002). Differences were confirmed with multivariate regression. CONCLUSION:Infants given bolus feeds reached goal feeds faster, required less time on PN, and were discharged quicker than those fed continuously. This suggests that, compared to continuous feeding, bolus feeding is associated with superior clinical outcomes among patients treated for medical NEC.