Objective: To report our experience of enteral feeding via gastrostomy in children with severe chronic neonatal lung disease, failure to thrive, and oral aversive behavior after initial hospitalization.
Population: Thirteen patients were studied. All children had chronic lung disease of neonatal onset and were severely malnourished. They received enteral nutrition via a gastrostomy at a median age of 13 months (range: 8–35).
Results: Z-scores for weight-for-height increased significantly, from −3.4 to −1.9 after four months of enteral nutrition. Caloric intake increased significantly from 100% to 140% of the recommended daily allowance for age. Pulmonary status remained stable for all patients and oxygenation was normal. There was an aggravation of oral aversive behavior in 7 of the 13 children, especially those children who were ventilated and hospitalized for a long time (median duration: 195 days). The median follow-up of patients after gastrostomy was 30 months (range: 8–54) and only six patients could be weaned from enteral nutrition.
Conclusion: Enteral nutrition via gastrostomy is efficient, and provides the means to improve caloric intake and nutritional status. Gastrostomy is a safe and convenient technique that should be considered early in the course of treatment for infants presenting with malnutrition related to neonatal pulmonary disease.
From the Departments of *Pediatric Gastroenterology and Nutrition, †Neonatology and ‡Pediatric Pulmonology, University Hospital, and Faculty of Medicine Lille, France
Received September 13, 2001; accepted September 18, 2002.
Address correspondence to F. Gottrand, Unité d' Hépatologie, Gastroentérologie et Nutrition Pédiatriques, Hôpital Jeanne de Flandre, 2 Avenue Oscar Lambret, 59037 Lille, France (e-mail: email@example.com).
This article is accompanied by an editorial. Please see Improving Nutritional Support in Chronic Lung Disease. R. Hankard. J Ped Gastroenterol Nutr 2003;36:432–433.