title: Enteral Feeding with Human Milk Decreases Time to Discharge in Infants following Gastroschisis Repair.
abstract: OBJECTIVE
  To assess the effect of enteral feeding with human milk on the time from initiation of feeds to discharge after gastroschisis repair through review of a multi-institutional database.
  
  
  METHODS
  Infants who underwent gastroschisis repair between 1997 and 2012 with data recorded in the Pediatrix Medical Group Clinical Data Warehouse were categorized into 4 groups based on the percentage of days fed human milk out of the number of days fed enterally. Cox proportional hazards regression modeling was performed to determine the adjusted effect of human milk on the time from initiation of feeds to discharge.
  
  
  RESULTS
  Among 3082 infants, 659 (21%) were fed human milk on 0% of enteral feeding days, 766 (25%) were fed human milk on 1%-50% of enteral feeding days, 725 (24%) were fed human milk on 51%-99% of enteral feeding days, and 932 (30%) were fed human milk on 100% of enteral feeding days. Following adjustment, being fed human milk on 0% of enteral feeding days was associated with a significantly increased time to discharge compared with being fed human milk on 100% of enteral feeding days (hazard ratio [HR] for discharge per day, 0.46; 95% CI, 0.40-0.52). The same was found for infants fed human milk on 1%-50% of enteral feeding days (HR, 0.37; 95% CI, 0.32-0.41) and for infants fed human milk on 51%-99% of enteral feeding days (HR, 0.51; 95% CI, 0.46-0.57).
  
  
  CONCLUSIONS
  The use of human milk for enteral feeding of infants following repair of gastroschisis significantly reduces the time to discharge from initiation of feeds.
authors.affiliation: Department of Surgery, Duke University Medical Center, Durham, NC; Duke Clinical Research Institute, Duke University Medical Center, Durham, NC.
authors.forename: Brian C
authors.initials: BC
authors.lastname: Gulack
authors.affiliation: Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Laughon
authors.affiliation: Pediatrix Medical Group, Inc, Sunrise, FL.
authors.forename: Reese H
authors.initials: RH
authors.lastname: Clark
authors.affiliation: Duke Clinical Research Institute, Duke University Medical Center, Durham, NC.
authors.forename: Terrance
authors.initials: T
authors.lastname: Burgess
authors.affiliation: Duke Clinical Research Institute, Duke University Medical Center, Durham, NC.
authors.forename: Sybil
authors.initials: S
authors.lastname: Robinson
authors.affiliation: Duke Clinical Research Institute, Duke University Medical Center, Durham, NC.
authors.forename: Abdurrauf
authors.initials: A
authors.lastname: Muhammad
authors.affiliation: Duke Clinical Research Institute, Duke University Medical Center, Durham, NC.
authors.forename: Angela
authors.initials: A
authors.lastname: Zhang
authors.affiliation: Duke Clinical Research Institute, Duke University Medical Center, Durham, NC.
authors.forename: Adrienne
authors.initials: A
authors.lastname: Davis
authors.affiliation: Duke Clinical Research Institute, Duke University Medical Center, Durham, NC.
authors.forename: Robert
authors.initials: R
authors.lastname: Morton
authors.affiliation: Department of Medicine, Duke University Medical Center, Durham, NC.
authors.forename: Vivian H
authors.initials: VH
authors.lastname: Chu
authors.affiliation: Department of Medicine, Duke University Medical Center, Durham, NC.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Arnold
authors.affiliation: Duke Clinical Research Institute, Duke University Medical Center, Durham, NC; Department of Pediatrics, Duke University Medical Center, Durham, NC.
authors.forename: Christoph P
authors.initials: CP
authors.lastname: Hornik
authors.affiliation: Duke Clinical Research Institute, Duke University Medical Center, Durham, NC; Department of Pediatrics, Duke University Medical Center, Durham, NC. Electronic address: brian.smith@duke.edu.
authors.forename: P Brian
authors.initials: PB
authors.lastname: Smith
mesh_terms: D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D020139:Gastroschisis / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007441:Intubation, Gastrointestinal; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008895:Milk, Human; D010351:Patient Discharge; D016016:Proportional Hazards Models; D011446:Prospective Studies; D013997:Time Factors