Feeding practices for infants with gastroschisis: A survey of neonatal intensive care units in Canada.

Abstract

BackgroundFeeding practices for infants with gastroschisis are often based on institutional protocols, clinician judgement, and usual practice. The purpose of this study was to describe the range of feeding practices used in neonatal intensive care units across Canada.MethodsWe developed an 18-item survey with open-ended questions focused on feeding and nutrition among infants with gastroschisis. Clinicians from neonatal intensive care units that manage infants with gastroschisis were invited to participate. Interviews were completed via virtual meeting or email. Data were analyzed using descriptive statistics.ResultsSemi-structured interviews were conducted with 14 of 17 centers (82% response rate). Participants included neonatologists (12/14 centers) and dieticians (10/14 centers). Pediatric surgeons from 3/14 centers participated at the request of neonatologists. None of the centers reported using a gastroschisis feeding protocol routinely, although two centers noted occasional use of a protocol from another hospital, and another indicated that a gastroschisis feeding protocol is in development. All centers reported that patients with gastroschisis qualify for donor human milk if maternal breast milk is unavailable. Routine use of sham feeding, contrast studies, rectal irrigations, or motility agents was not reported. There was variation between centers regarding feeding advancement, type of formula used if breast milk is unavailable, use of probiotics, and strategies to introduce breastfeeding.ConclusionThere is variation in some but not all aspects of enteral feeding among infants with gastroschisis at neonatal intensive care units in Canada. The development of institutional feeding protocols and clinical practice guidelines may help standardize practice.