Comparison of Infants Discharged from Birth Hospitalization with Gastrostomy versus Nasogastric Feeding Tube

Hartlee Lidsky; Emily Anderson; Neal A. deJong; Adriana Herrera; Ashley G. Sutton

doi:10.1055/a-2550-5510

American Journal of Perinatology, Table of Contents

Am J Perinatol
DOI: 10.1055/a-2550-5510

Original Article

Comparison of Infants Discharged from Birth Hospitalization with Gastrostomy versus Nasogastric Feeding Tube

Hartlee Lidsky

¹University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina

,

Emily Anderson

²Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina

,

Neal A. deJong

³Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina

,

Adriana Herrera

⁴Division of Hospital Pediatrics, Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina

,

Ashley G. Sutton

⁴Division of Hospital Pediatrics, Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina

› Author Affiliations

Abstract

Objective

Many infants, particularly those born premature or with medical complexity, require supplemental enteral nutrition upon discharge from birth hospitalization. Recent literature supports the safety of discharging infants with nasogastric tube (NG) feeding. However, further evidence is needed to characterize populations suited for home NG feeding compared to gastrostomy tube (GT) placement. This study aimed to describe demographic and clinical differences between infants discharged from birth hospitalization with NG versus GT feeding.

Study Design

This retrospective cohort study included infants discharged from birth hospitalization with NG or GT feeding between April 2014 and December 2022 at a single quaternary care hospital with a neonatal intensive care unit (NICU). Routinely collected health data were used to investigate associations between patient characteristics and discharge feeding modality, as well as assess feeding outcomes 12 months after discharge.

Results

Of 346 infants, 72 (20.8%) were discharged with NG and 274 (79.2%) with GT. Infants with GT were more often discharged from the NICU (71.2 vs. 26.4%) with lower birth weights (median 2.40 vs. 2.92 kg) and longer hospitalizations (median 84 vs. 51.5 days). Twelve months after discharge, 77.4% of NG infants achieved full oral feeding compared to 16.6% of GT infants with earlier tube discontinuation in NG infants (19 vs. 236 days).

Conclusion

Home NG feeding is a viable, less invasive alternative to GT for selected infants, particularly those with less medical complexity. Prospective studies are needed to further delineate optimal discharge feeding modalities for various infant subpopulations.

Key Points

Infants discharged with gastrostomies had lower birth weights.
More NG tube infants achieved oral feeding than gastrostomy infants.
NG tubes were removed much sooner than GT.
Home NG feeding is an alternative to gastrostomy for less medically complex infants.

Keywords

enteral nutrition - enteral feeding tube - neonates - oral feeding dysfunction - home enteral feeding - nasogastric - gastrostomy

Full Text

References

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