Early enteral nutrition for upper digestive tract malformation in neonates

Background: Early enteral nutrition (EEN) is better than total parenteral nutrition (TPN) for many reasons. Our aim was to determine the safety and feasibility of EEN using a jejunum feeding tube in the duodenum or jejunum for congenital obstruction in neonates post-operatively. Methods: This was a retrospective review of 120 patients who had duodenal and jejunal congenital obstructions in our hospital. The patients were categorized into two groups (EEN group [n=70 patients] and control group [n=50 patients]). Differences in operative time, postoperative time to tolerate oral feeding (40 mL/3 h), post-operative hospital stay, and complications, such as catheter obstruction, diarrhea, and nutrition index, were reviewed. Results: The operative time and time to first defecation post-operatively was not significantly different between the two groups. The time to tolerate oral feeding (40 inL/3 h) and the hospital length of stay post-operatively for the EEN group were significantly shorter than the control group. Total protein, pre-albumin, and retinol binding protein were significantly higher in the EEN group than the control group 14 days post-operatively. The incidence of cholestasis and obstruction in the EEN group was significantly lower than the control group, and the incidence of diarrhea was lower than the control group, but not significantly lower. Conclusion: EEN using a jejunal feeding tube in an upper digestive tract malformation in newborns post-operatively is safe, easy, and has fewer complications.