title: Early feeding in pediatric patients following stoma closure in a resource limited environment.
abstract: BACKGROUND
  Establishment of enteral nutrition is necessary after intestinal surgery. In resource-strained environments, it can be critical. This study examined the effect of early feeding in pediatric patients undergoing stoma closure in a country with mid-level socioeconomic indices.
  
  
  METHODS
  With parenteral consent and ethics board approval, patients were prospectively enrolled in early feeding (Group 1), starting feeds 24h post-operation with a protocol driven increase. They were compared with similar patients managed without a specific protocol over the 12 months prior (Group 2).
  
  
  RESULTS
  There were 31 patients in each group with similar mean age and weight. The mean first sustained feed was achieved at 28.5 ± 4.4 h* in Group 1 vs. 153.8 ± 28.6 h in Group 2. Full feeds were achieved within 62.3 ± 19.2 h* vs. 196.0 ± 40.5 h in Group 1 and 2, respectively. Mean hospital stay was 7.2 days* in Group 1 vs. 9.4 days in Group 2. A reduction in postoperative fever and wound infections was observed in Group 1 (*p<0.05).
  
  
  CONCLUSIONS
  Early enteral feeding after elective bowel anastomosis is well tolerated in children and results in shorter hospital stay and fewer complications.
authors.affiliation: Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi 110001, India.
authors.forename: Partap S
authors.initials: PS
authors.lastname: Yadav
authors.forename: S Roy
authors.initials: SR
authors.lastname: Choudhury
authors.forename: Jitendra Kumar
authors.initials: JK
authors.lastname: Grover
authors.forename: Amit
authors.initials: A
authors.lastname: Gupta
authors.forename: Rajiv
authors.initials: R
authors.lastname: Chadha
authors.forename: David L
authors.initials: DL
authors.lastname: Sigalet
mesh_terms: D000714:Anastomosis, Surgical; D002648:Child; D002675:Child, Preschool; D003125:Colostomy; D003906:Developing Countries; D004065:Digestive System Abnormalities / Q000601:surgery; D017558:Elective Surgical Procedures; D004750:Enteral Nutrition / Q000191:economics; D005260:Female; D005334:Fever / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D007081:Ileostomy; D007194:India; D007223:Infant; D007441:Intubation, Gastrointestinal; D008297:Male; D011182:Postoperative Care / Q000191:economics; D011183:Postoperative Complications / Q000453:epidemiology; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology; D054047:Surgical Stomas; D013530:Surgical Wound Infection / Q000453:epidemiology