Early Enteral Feeding in Neonates Undergoing Esophageal Atresia Repair Surgery

Neonates have limited reserves of energy. In esophageal atresia (EA) repair surgery, there were concerns about feeding initiation due to the location of the surgery.

To determine the effect of early enteral feeding on feeding tolerance and the duration of hospital stayin neonates with esophageal atresia.

In this randomized clinical trial, 48 neonates who underwent type-C esophageal atresia surgery at Dr. Sheikh (a subspecialty centers in eastern Iran), July 2015 - November 2017 were randomly divided into the intervention and control groups. In the intervention group, 48 hours after surgery, feeding was initiated once the absence of anastomotic leakage was confirmed by a chest X-ray. The control group received routine feeding from the fifth day after surgery. Feeding tolerance and length of hospital stay (LOS) were compared. Data were analyzed in SPSS-16 using Fisher's exact and Independent sample T tests.

The mean weight before intervention was 2550.1±523.4 grams in control and 2540.6±856.0 grams in intervention groups. Results revealed no significant differences between the intervention and control groups in the frequency of feeding volume tolerance (P=0.48). The mean duration of NGT feeding , time to achieve complete oral feeding and LOS were significantly lower in the intervention group (P<0.05).

Implications for Practice: 

In EA repair surgery early enteral feeding improved feeding tolerance and decreased LOS. So the approach to feeding after EA repair surgery is recommended to be reviewed, and considering patient’s condition, can be started earlier even from 48th hours after surgery.