title: Enemas, suppositories and rectal stimulation are not effective in accelerating enteral feeding or meconium evacuation in low-birthweight infants: a systematic review.
abstract: Early full enteral feeding in preterm infants decreases morbidity and mortality. Our systematic review covered the effectiveness of rectal stimulation, suppositories and enemas on stooling patterns and feeding tolerance in low-birthweight infants born at up to 32 weeks. It comprised seven studies published between 2007 and 2014 and covered 495 infants.
  
  
  CONCLUSIONS
  Suppositories were ineffective in shortening the time to reach full enteral feeding, and the evidence on enemas was contradictory. Enemas and rectal stimulation did not shorten the time until complete meconium evacuation was reached. Further research into safe, effective interventions to accelerate meconium excretion is needed.
authors: Department of Neonatology, Lucas Hospital, Apeldoorn, The Netherlands.|Department of Gynecology, Obstetrics, Reproductive Medicine and Children, Deventer Hospital, Deventer, The Netherlands.|Department Clinical Health Science, University Utrecht, Utrecht, The Netherlands.
authors: Kim
authors: K
authors: Kamphorst
authors: Department Clinical Health Science, University Utrecht, Utrecht, The Netherlands.|Department Viaa, Christian University of Applied Sciences, Zwolle, The Netherlands.
authors: Ydelette
authors: Y
authors: Sietsma
authors: Department Clinical Health Science, University Utrecht, Utrecht, The Netherlands.|Intensive Care Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors: Annemieke J
authors: AJ
authors: Brouwer
authors: Department Clinical Health Science, University Utrecht, Utrecht, The Netherlands.|Department of Intensive Care Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors: Paul J T
authors: PJ
authors: Rood
authors: Department Clinical Health Science, University Utrecht, Utrecht, The Netherlands. ahoogen@umcutrecht.nl.|Intensive Care Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands. ahoogen@umcutrecht.nl.
authors: Agnes
authors: A
authors: van den Hoogen
mesh_terms: D003672:Defecation / Q000502:physiology*; D004733:Enema / Q000379:methods*; D004750:Enteral Nutrition / Q000379:methods*; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D008470:Meconium / Q000378:metabolism*; D010812:Physical Stimulation / Q000379:methods*; D013488:Suppositories / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D013488:Suppositories
keywords: Enemas; Feeding tolerance; Low-birthweight infants; Meconium excretion; Suppositories