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Feeding Gastrostomy in Premature Infants

Feeding Gastrostomy in Premature Infants Abstract PREMATURITY is a major contributing factor to neonatal mortality. The premature infant has lower nutritional reserves, is more susceptible to infections, and has a more fragile vascular system than his full-term counterpart. In addition, sucking and swallowing result in fatigue, with increasing nutritional deficits and a higher incidence of aspiration pneumonia. The mortality and morbidity from all of these factors increase strikingly in infants weighing less than 1,250 gm (2 lb 12 oz) at birth. Pediatricians routinely attempt to overcome these difficulties by either delaying the nourishment of small premature infants or with gavage, intravenous, or medicine-dropper feedings. Several investigators have suggested feeding gastrostomies to prevent aspiration and to minimize the handling, and resulting fatigue, of the baby. Berg et al performed 11 gastrostomies which resulted in four early deaths from respiratory failure.1 They suggested delaying the operation for two or three days until the danger of hyaline membrane References 1. Berg, R.B.; Schuster, S.R.; and Colodney, A.H.: The Use of Gastrostomy in Feeding Premature Infants , Pediatrics 33:287, 1964. 2. Tomsovic, E.J., et al: Feeding Gastrostomy in Small Premature Infants , Amer J Dis Child 112:56 ( (July) ) 1966. 3. Martin, L.W., and Fultz, T.: The Use of Gastrostomy in Pediatric Surgery , Arch Surg 78:904-905 ( (June) ) 1959.Crossref 4. Holder, T.M., and Gross, R.E.: Temporary Gastrostomy in Pediatric Surgery: Experience with 187 cases , Pediatrics 26:36 ( (July) ) 1960. 5. Meeker, I.A., and Snyder, W.H.: Gastrostomy for the Newborn Surgical Patient , Amer J Dis Child 37:159, 1962.Crossref 6. Haws, E.B.; Sieber, W.K.; and Kiesewetter, W.B.: Complications of Tube Gastrostomy in Infants and Children: Fifteen Year Review of 240 Cases , Ann Surg 164:284, 1966.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1968 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1968.01340020054005
Publisher site
See Article on Publisher Site

Abstract

Abstract PREMATURITY is a major contributing factor to neonatal mortality. The premature infant has lower nutritional reserves, is more susceptible to infections, and has a more fragile vascular system than his full-term counterpart. In addition, sucking and swallowing result in fatigue, with increasing nutritional deficits and a higher incidence of aspiration pneumonia. The mortality and morbidity from all of these factors increase strikingly in infants weighing less than 1,250 gm (2 lb 12 oz) at birth. Pediatricians routinely attempt to overcome these difficulties by either delaying the nourishment of small premature infants or with gavage, intravenous, or medicine-dropper feedings. Several investigators have suggested feeding gastrostomies to prevent aspiration and to minimize the handling, and resulting fatigue, of the baby. Berg et al performed 11 gastrostomies which resulted in four early deaths from respiratory failure.1 They suggested delaying the operation for two or three days until the danger of hyaline membrane References 1. Berg, R.B.; Schuster, S.R.; and Colodney, A.H.: The Use of Gastrostomy in Feeding Premature Infants , Pediatrics 33:287, 1964. 2. Tomsovic, E.J., et al: Feeding Gastrostomy in Small Premature Infants , Amer J Dis Child 112:56 ( (July) ) 1966. 3. Martin, L.W., and Fultz, T.: The Use of Gastrostomy in Pediatric Surgery , Arch Surg 78:904-905 ( (June) ) 1959.Crossref 4. Holder, T.M., and Gross, R.E.: Temporary Gastrostomy in Pediatric Surgery: Experience with 187 cases , Pediatrics 26:36 ( (July) ) 1960. 5. Meeker, I.A., and Snyder, W.H.: Gastrostomy for the Newborn Surgical Patient , Amer J Dis Child 37:159, 1962.Crossref 6. Haws, E.B.; Sieber, W.K.; and Kiesewetter, W.B.: Complications of Tube Gastrostomy in Infants and Children: Fifteen Year Review of 240 Cases , Ann Surg 164:284, 1966.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Aug 1, 1968

References