1. Enteral Feeding with Human Milk Decreases Time to Discharge in Infants following Gastroschisis Repair
- Author
-
Brian C. Gulack, Terrance Burgess, Angela Zhang, Christoph P. Hornik, Christopher Arnold, Adrienne L. Davis, Robert Morton, Abdurrauf Muhammad, Matthew M. Laughon, Vivian H. Chu, Sybil Robinson, Reese H. Clark, and P. Brian Smith
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Neonatal intensive care unit ,Enteral administration ,Article ,03 medical and health sciences ,Enteral Nutrition ,0302 clinical medicine ,Animal science ,Intensive Care Units, Neonatal ,030225 pediatrics ,Cox proportional hazards regression ,medicine ,Humans ,Prospective Studies ,030212 general & internal medicine ,Prospective cohort study ,Intubation, Gastrointestinal ,Proportional Hazards Models ,Gastroschisis ,Milk, Human ,business.industry ,Hazard ratio ,Infant, Newborn ,food and beverages ,Length of Stay ,medicine.disease ,Patient Discharge ,Surgery ,Parenteral nutrition ,Pediatrics, Perinatology and Child Health ,Necrotizing enterocolitis ,Female ,business - 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. Study design 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). Conclusion The use of human milk for enteral feeding of infants following repair of gastroschisis significantly reduces the time to discharge from initiation of feeds.
- Published
- 2016