Minimal enteral nutrition during neonatal hypothermia treatment for perinatal hypoxic-ischaemic encephalopathy is safe and feasible

Abstract

Aim: The safety and efficacy of enteral feeding during hypothermia treatment following hypoxic-ischaemic encephalopathy has not been studied before, resulting in variations in practice. Our study compared the benefits and safety of both early minimal and delayed enteral feeding during hypothermia treatment.

Methods: Our retrospective cohort study, from January 2009 to December 2011, compared a Swedish cohort, who received early enteral feeding during hypothermia, and a UK cohort, who received delayed enteral feeding.

Results: In Sweden (n = 51), enteral feeds were initiated at a median of 23.6 h and full oral feeding was achieved at 9 days (range 3-23). In the UK (n = 34), the equivalent figures were 100 h and 8 days (range 3-13) (p = 0.01). Both groups achieved enteral feeding at a median 6 days. The median length of hospital stay was 13 days in Sweden and 10 days in the UK (p = 0.04). More babies were fully breastfeeding or breastfed and bottle-fed at discharge in Sweden (85%) than the UK (67%) (p = 0.08). There were no significant differences between the two groups regarding adverse events.

Conclusion: Early minimal enteral feeding during hypothermia proved feasible, with no significant complications. Delayed enteral feeding did not affect time to full enteral feeding.

Keywords: Breastfeeding; Enteral nutrition; Hypothermia; Perinatal hypoxic-ischaemic encephalopathy.