THE PREVALENCE OF FEEDING INTOLERANCE IN PRETERM NEONATES ATTENDING A TERTIARY CARE HOSPITAL, BANGLADESH

Dr. Shahana Ferdous* and Md. Faysal Ahmmed

ABSTRACT

Background: Feeding intolerance is common in premature newborns and is strongly linked to morbidity and mortality. All pediatricians will eventually have to deal with this formidable obstacle. When clinical symptoms such as vomiting, diarrhea, or abdominal pain arise as a result of ingestion or digestion of milk, this is known as feeding intolerance. Objective: To evaluate the prevalence of feeding intolerance in preterm neonates in neonatal intensive care units. Method: This prospective study was carried out on 40 preterm neonates admitted to Neonatal Intensive Care Unit of Khulna City Medical College and Hospital, Khulna from 1st January 2022 to 31st December 2022. Inclusion criteria of the study were admitted preterm infants of both genders from day 0 to day 28 of life and with gestational age (GA) from 28 to 36 weeks (estimated by 1st day of maternal last menstrual period). Diagnosis of feeding intolerance considered by the presence of one or more signs that leading to interruption of the enteral feeding regime of the preterm as increased gastric residuals (>50%) of the previous feeding, greenish residual, hemorrhagic residual, emesis, abdominal distention (increase in abdominal girth by 2 cm or more in between feedings), bloody stool, diarrhea, visible bowel loops and apnea. Results: During the study 10% had feeding intolerance. Mean gestational age was found 32.2±2.3 weeks with range from 28 to 36 weeks. The mean birth weight was found 1866.5±529.9 gram with range from 950 to 2800 gram. The mean time of feeding intolerance diagnosis was found 6.1±4.2 days with range from 2 to 15 days. 70% patients had feeding intolerance who was born in 28-32 weeks and 30% was in 33-35 weeks of gestation. Majority (52.5%) patients had vomiting, 37.5% had abdominal distension, 20% had gastric residual, 15% had apnea, 12.5% had greenish residual and 12.5% had hemorrhagic residual. 45% patients was found with respiratory distress followed by 37.5% with respiratory distress syndrome, 10% with necrotizing enterocolitis, 5% with transient tachypnea of the newborn and 5% with hypoxic ischemic encephalopathy. Conclusion: The feeding of preterm neonates is one of the main challenges facing the neonatologist. Feeding intolerance can be defined by difficulty in ingestion or digestion of the milk that causes a disruption in the enteral feeding plan due to the manifestation of clinical symptoms. In our study through cases of feeding indolence has limited but frequency of symptoms and morbidities were higher.

Keywords: feeding intolerance, preterm neonates. neonatal intensive care units.