Bowel habits in preterm infants: Observations from the first 2 weeks of life.

Abstract

Objectives: Uniform descriptions of normal preterm infant bowel habits are lacking, causing ambiguity in identifying abnormal bowel habits in this population. This study examines preterm infants' bowel habits and their association with maternal and infant factors in the first 2 weeks of life.

Methods: An observational study included infants with a gestational age (GA) < 31 weeks from January to September 2021. From infant and maternal medical records, information on prenatal events, 2 weeks of bowel habit observations, enteral feeding, and laxative treatment was obtained. Extremely preterm infants (EPI) and very preterm infants (VPIs) were defined as GA < 28 weeks and GA ≥ 28 weeks, respectively.

Results: Of the 93 infants, 53 (57%) were included, and 37 (70%) were EPI. EPI received first enteral feeds at a median of 5 h after birth versus 2 h after birth in VPI (p < 0.01). EPI passed their first meconium at a median of 30 h (interquartile range [IQR] 12-49 h) after birth versus 26 h in VPI (IQR: 10-40, p = 0.2). In 21% of all infants, saline enemas were used to induce the passage of meconium. In 41% of EPIs (n = 15) laxatives were initiated before 2 weeks of age. Stool frequency varied from 0 to 9 stools daily, and prenatal events did not affect bowel habits.

Conclusion: This study provides a day-by-day description of bowel habits, enteral feeds, and laxative treatment but shows no associations with prenatal events in preterm infants. For future research, we recommend implementing homogeneous observation tools to enable comparison between studies.