title: Acquisition of full enteral feeds may depend on stooling pattern in very premature infants.
abstract: OBJECTIVE
  The objective of this study was to determine whether acquisition of normal stooling pattern is associated with full enteral feeding and growth.
  
  
  METHODS
  This is a prospective observational study of infants with a gestational age of <28 weeks (n=121). All infants admitted to our unit during the study period were managed using the same protocol for rectal stimulation and enemas: we used rectal stimulation if abdominal distension and no defecation occurred in the previous 24 h; enema administration was practiced if abdominal distension persists and no defecation had occurred after rectal stimulation. Age of normal bowel habit (T-NBH) is defined as days when two stools passed each day without enemas or stimulation for three consecutive days. Full enteral feeding is measured by time to receive 120 mL/kg/day (T-120). Multivariable linear regression estimated the contribution of T-NBH on T-120 and the effect of tolerance on growth.
  
  
  RESULTS
  T-NBH was 16 days (12, 24 days) and T-120 was 16 days (12, 24 days). T-120 decreased with earlier normal bowel habit (r=0.625, P<0.0001). Change in weight z-score between 36 weeks postmenstrual age and birth was less pronounced with earlier full enteral feeding (r=-0.446, P<0.0001).
  
  
  CONCLUSIONS
  Normalization of bowel habit is an important determinant of full enteral feeding of very immature infants. Earlier full enteral feeding is associated with less postnatal growth failure.
authors: Department of Neonatology, La Paz University Hospital, P. de la Castellana 261, Madrid, Spain. msaenz.hulp@salud.madrid.org
authors: Miguel Sáenz
authors: MS
authors: de Pipaón Marcos
authors: Ma Teresa
authors: MT
authors: Montes Bueno
authors: Belén
authors: B
authors: SanJosé
authors: Esmeralda
authors: E
authors: Torralba
authors: Milagros
authors: M
authors: Gil
authors: Isabel
authors: I
authors: Parada
authors: Pilar
authors: P
authors: Amo
mesh_terms: D003672:Defecation / Q000502:physiology*; D004750:Enteral Nutrition; D005260:Female; D041981:Gastrointestinal Tract / Q000254:growth & development / Q000502:physiology; D005772:Gastrointestinal Transit / Q000502:physiology; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development / Q000502:physiology*; D008297:Male; D010812:Physical Stimulation; D011446:Prospective Studies; D012007:Rectum