Ad libitum feeding after surgery for pyloric stenosis.

Background: Pyloric stenosis is one of the most common reasons for surgery in infants. Standard practice has traditionally been to gradually increase feeding volumes postoperatively. In 2018, Oslo University Hospital, Ullevål introduced ad libitum feeding following surgery for pyloric stenosis. We aimed to investigate whether the new feeding regimen affected the frequency of postoperative complications and length of hospital stay.

Material and method: A retrospective study of children who underwent surgery for pyloric stenosis at Oslo University Hospital, Ullevål in the period 2004-2021. Data were collected on sex, age, birth weight, comorbidities, feeding regimen, in addition to perioperative and postoperative data.

Results: We included 210 patients in the study, including 188 boys. A total of 47 patients received ad libitum feeding postoperatively, while feeding volumes were gradually increased in 163 patients. The groups were similar in terms of sex, age, birth weight and comorbidity. There were no significant differences in postoperative complications, reoperations, readmissions or late complications between the groups. Postoperative length of hospital stay was significantly shorter in the group that received ad libitum feeding compared to the group whose feeding was gradually increased (2.7 vs. 3.7 days, p < 0.001).

Interpretation: A shorter hospital stay following surgery for pyloric stenosis was observed following the introduction of ad libitum feeding, with no increase in the incidence of complications. This may be attributed to changes in the feeding regimen, changes in the surgical technique, or temporal factors.