Breast-Milk Enema Administration to Stimulate Meconium Passage in Preterm Infants
Wake Forest University Health Sciences
Summary
Lack of passage of meconium in preterm infants delays feeding advancement and may represent a risk factor for necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP). Usual management of meconium impaction has included glycerin suppositories and normal saline enemas. Various methods are used in routine neonatal care to promote meconium evacuation; however, there is no consensus on the agents used and the frequency of applications
Description
Breast milk is a natural oil-in-water emulsion that can soften meconium, lubricate, and stimulate the intestinal wall, making it easier to excrete meconium. The osmotic pressure of breast milk is a benign stimulus to the digestive tract of premature infants. In addition, breast milk contains bioactive compounds that may positively influence gut motility and the microbiome and has been shown to decrease the incidence of NEC. A small-volume rectal enemas using mother's own breast milk in preterm infants born at \<28 weeks' gestation with delayed passage of meconium (\>48 hours of life) are feasi…
Eligibility
- Age range
- 0–0 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Preterm infants born at \>23 and \<28 weeks' gestational age born at Atrium Health Wake Forest Baptist Hospital or transferred in the first 24 hours of life. * postnatal age \>48 hours, absence of spontaneous passage of meconium by \>48 hours of life * availability of mother's own milk * written informed consent obtained from a parent or legal guardian. Exclusion Criteria: * Infants with Necrotizing Enterocolitis (NEC) ≥ stage II * spontaneous intestinal perforation (SIP) * gastrointestinal or anorectal malformations * infants that have developed severe hemodynamic ins…
Interventions
- Drugbreast milk
A small-volume rectal enema consisting of 5 mL/kg of fresh mother's own breast milk will be administered as a single dose, with the option for one repeat dose at 24 hours if clinically indicated.
Location
- Wake Forest University Health SciencesWinston-Salem, North Carolina