Suntharalingam Hareshan, Briatico Daniel, Carey Nathalie, McBryde Ali, Skarsgard Erik, Huisman Esther, Livingston Michael H
McMaster Pediatric Surgery Research Collaborative, Hamilton, ON, Canada.
Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
J Neonatal Perinatal Med. 2025 Jul;18(4):312-320. doi: 10.1177/19345798251327370. Epub 2025 Mar 17.
BackgroundFeeding practices for infants with gastroschisis are often based on institutional protocols, clinician judgement, and usual practice. The purpose of this study was to describe the range of feeding practices used in neonatal intensive care units across Canada.MethodsWe developed an 18-item survey with open-ended questions focused on feeding and nutrition among infants with gastroschisis. Clinicians from neonatal intensive care units that manage infants with gastroschisis were invited to participate. Interviews were completed via virtual meeting or email. Data were analyzed using descriptive statistics.ResultsSemi-structured interviews were conducted with 14 of 17 centers (82% response rate). Participants included neonatologists (12/14 centers) and dieticians (10/14 centers). Pediatric surgeons from 3/14 centers participated at the request of neonatologists. None of the centers reported using a gastroschisis feeding protocol routinely, although two centers noted occasional use of a protocol from another hospital, and another indicated that a gastroschisis feeding protocol is in development. All centers reported that patients with gastroschisis qualify for donor human milk if maternal breast milk is unavailable. Routine use of sham feeding, contrast studies, rectal irrigations, or motility agents was not reported. There was variation between centers regarding feeding advancement, type of formula used if breast milk is unavailable, use of probiotics, and strategies to introduce breastfeeding.ConclusionThere is variation in some but not all aspects of enteral feeding among infants with gastroschisis at neonatal intensive care units in Canada. The development of institutional feeding protocols and clinical practice guidelines may help standardize practice.
背景
腹裂婴儿的喂养方式通常基于机构规程、临床医生的判断和常规做法。本研究的目的是描述加拿大各地新生儿重症监护病房所采用的喂养方式范围。
方法
我们制定了一项包含18个项目的调查问卷，其中有开放式问题，重点关注腹裂婴儿的喂养和营养情况。邀请了管理腹裂婴儿的新生儿重症监护病房的临床医生参与。访谈通过虚拟会议或电子邮件完成。使用描述性统计方法对数据进行分析。
结果
对17个中心中的14个（回复率82%）进行了半结构化访谈。参与者包括新生儿科医生（14个中心中的12个）和营养师（14个中心中的10个）。应新生儿科医生的要求，14个中心中的3个中心的小儿外科医生也参与了访谈。尽管有两个中心指出偶尔会使用另一家医院的规程，还有一个中心表示正在制定腹裂喂养规程，但没有一个中心报告常规使用腹裂喂养规程。所有中心都报告说，如果没有母乳，腹裂患者有资格使用捐赠的母乳。没有报告常规使用假喂养、造影检查、直肠冲洗或动力药物。各中心在喂养进展、无母乳时使用的配方奶类型、益生菌的使用以及引入母乳喂养的策略方面存在差异。
结论
加拿大新生儿重症监护病房中，腹裂婴儿肠内喂养的某些方面存在差异，但并非所有方面都如此。制定机构喂养规程和临床实践指南可能有助于规范实践。
