The Incidence of Feeding Intolerance in the Full Term Neonates with Hypoxic-Ischemic Encephalopathy.

Song,  Young Gue; Choi,  Sung Dong; Hur,  Jae Kyun; Oh,  Chang Kyu; Chun,  Chung Sik

Original Article

Journal of the Korean Society of Neonatology 2002;9(2):192-197.
Published online November 1, 2002.

The Incidence of Feeding Intolerance in the Full Term Neonates with Hypoxic-Ischemic Encephalopathy.

Young Gue Song, Sung Dong Choi, Jae Kyun Hur, Chang Kyu Oh, Chung Sik Chun

Department of Pediatrics, Catholic University Medical College, Seoul, Korea. donghwa4@hitel.net

저산소성 허혈성 뇌증이 있는 만삭아에서 수유장애 빈도

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Abstract

PURPOSE
We investigated incidence of feeding intolerance and time when normal enteral feeding can be established in full term neonates with hypoxic-ischemic encephalopathy (HIE).
METHODS
We reviewed medical records of 61 full term infants with HIE who were admitted to St. Paul's Hospital from Jan. 1996 to Dec. 2001. The incidence of feeding intolerance, day of first feeding, and day of full enteral feeding were studied in respective to Sarnat stages.
RESULTS
Among the full term with HIE, 32 were classified into stage I, 20 into stage II, and 9 into stage III. The incidence of feeding intolerance was 6%, 30%, and 89% for stages I, II and III, respectively. There was only one case of necrotizing enterocolitis among infants of stage III HIE. Feeding first began on 0.13+/-0.01 postnatal day (PND) in normal infants compared to 0.15+/-0.03 PND in infants of stage I, 3.24+/-1.82 PND in stage II and 5.58+/-2.50 PND in stage III. The incidence of feeding intolerance, day of first feeding, and day of normal enteral feeding achieved in infants with stage I were not different from those of normal infants but significantly higher and delayed in infants with more severe degrees of encephalopathy.
CONCLUSION
The first feeding should vary according to severity of encephalopathy so as to lower the incidence of feeding intolerance and the risk of necrotizing enterocolitis. We suggest that infants of stageIencephalopathy be first fed as same as normal infants, but precaution is in order when deciding an appropriate time to start feeding in infants of stage II, III encephalopathy.

Key Words: Feeding; Hypoxic-ischemic encephalopathy; Neonate