title: Metoclopramide promotes enteral feeding in preterm infants with feeding intolerance.
abstract: We hypothesized that the feeding difficulties experienced by premature infants are related to immature peristaltic activity and that a bowel accelerant might promote feeding in prematures. We administered metoclopramide (Meto) to 14 infants admitted to the Intensive Care Nursery at The University of Chicago between January 1, 1984, and January 1, 1987. Each infant had failed enteral feeding on at least two separate occasions. At the time of initiation of Meto, the group of infants tolerated only 11.7 +/- (SEM) 3.6 cm3/kg/day enterally. Feeding tolerance improved steadily after Meto was initiated, and by 29 days the infants tolerated 134 +/- 12.6 cm3/kg/day enterally. The average slope of the post-Meto feeding regression lines was +4.21 +/- 0.94 cm3/kg/day/day, significantly greater than -0.67 +/- 0.59 cm3/kg/day/day pre-Meto. The percentage of feedings followed by significant gastric residual volumes was 33.1 +/- 4.6% pre-Meto, compared to 6.9 +/- 2.5% post-Meto. No child receiving Meto developed any extrapyramidal neurologic symptoms, worsening of hepatic function, or necrotizing enterocolitis. Meto may have a role in the treatment of premature infants with enteral feeding intolerance.
authors.affiliation: Department of Pediatrics, University of Chicago, Ill.
authors.forename: W L
authors.initials: WL
authors.lastname: Meadow
authors.forename: K C
authors.initials: KC
authors.lastname: Bui
authors.forename: E
authors.initials: E
authors.lastname: Strates
authors.forename: R
authors.initials: R
authors.lastname: Dean
mesh_terms: D004750:Enteral Nutrition; D005769:Gastrointestinal Motility / Q000187:drug effects; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D008787:Metoclopramide / Q000494:pharmacology / Q000627:therapeutic use*; D010528:Peristalsis / Q000187:drug effects
chemical_list: D008787:Metoclopramide