Download PDF
Eur J Pediatr Surg 2023; 33(05): 367-376
DOI: 10.1055/s-0042-1757360
Original Article

Feeding Practice, Nutrition, and Growth in Infants with Abdominal Wall Defects and Esophageal Atresia: A Retrospective Case–Control Study

Signe Sparre 
1   Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense C, Denmark
2   Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense C, Denmark
,
Gitte Zachariassen 
1   Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense C, Denmark
2   Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense C, Denmark
3   Odense Patient data Explorative Network, Odense University Hospital, Odense C, Denmark
,
Mark Bremholm Ellebæk 
4   Surgical Research Unit, Odense University Hospital, Odense C, Denmark; University of Southern Denmark, Odense, Denmark
,
Steffen Husby 
1   Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense C, Denmark
2   Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense C, Denmark
,
Kristina Garne Holm 
1   Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense C, Denmark
2   Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense C, Denmark
3   Odense Patient data Explorative Network, Odense University Hospital, Odense C, Denmark
› Author Affiliations Funding This work was funded by Odense University Hospital. The funding source was not involved in either the study design; data collection, analysis, and interpretation; writing of the report; or in the decision to submit the article for publication.
› Further Information
    Permissions and Reprints

Abstract

Introduction Infants born with abdominal wall defects and esophageal atresia (EA) are at risk of impaired growth. Little is known about the optimal nutritional strategy and its impact on growth for these infants. This study aims to explore nutrition, focusing on breastfeeding, and the presumed impact on infant growth during the first year of life.

Materials and Methods We performed a registry study. The participants comprised infants born with gastroschisis, omphalocele, or EA from 2009 to 2020. Breastfed healthy infants from the Odense Child Cohort served as the control group. Descriptive statistics were applied when presenting data on nutrition. Growth data were converted to weight z-scores at birth and at discharge, and estimated weight z-scores at 6 and 12 months were calculated. Univariate regression analysis was applied.

Results The study included 168 infants in the study group and 403 infants in the control group. Exclusive breastfeeding rates at discharge were as follows: 55.7% (gastroschisis), 58.3% (omphalocele), 50.9% (EA), and 7.7% (long-gap EA). For the study group our data demonstrate no difference in growth at 1 year of age when comparing mother's milk to formula feeding. During the first year of life, infants in the study group showed slower growth compared with the control group. At 12 months of age, all infants had a mean weight z-score above –2.

Conclusion Breastfeeding in infants with abdominal wall defects and EA can be established without compromising growth. Mother's milk can be recommended for infants with abdominal wall defects and EA.

Keywords

congenital abdominal wall defect - esophageal atresia - breastfeeding - growth


Publication History

Received: 11 April 2022

Accepted: 23 August 2022

Article published online:
31 December 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Escobar Jr MA, Caty MG. Complications in neonatal surgery. Semin Pediatr Surg 2016; 25 (06) 347-370
    CrossrefPubMedGoogle Scholar
  • 2 Traini I, Menzies J, Hughes J, Leach ST, Krishnan U. Oesophageal atresia: the growth gap. World J Gastroenterol 2020; 26 (12) 1262-1272
    CrossrefPubMedGoogle Scholar
  • 3 Bairdain S, Zurakowski D, Vargas SO. et al. Long-gap esophageal atresia is a unique entity within the esophageal atresia defect spectrum. Neonatology 2017; 111 (02) 140-144
    CrossrefPubMedGoogle Scholar
  • 4 Foker JE, Linden BC, Boyle Jr EM, Marquardt C. Development of a true primary repair for the full spectrum of esophageal atresia. Ann Surg 1997; 226 (04) 533-541 , discussion 541–543
    CrossrefPubMedGoogle Scholar
  • 5 Oluwafemi OO, Benjamin RH, Navarro Sanchez ML. et al. Birth defects that co-occur with non-syndromic gastroschisis and omphalocele. Am J Med Genet A 2020; 182 (11) 2581-2593
    CrossrefPubMedGoogle Scholar
  • 6 Gamba P, Midrio P. Abdominal wall defects: prenatal diagnosis, newborn management, and long-term outcomes. Semin Pediatr Surg 2014; 23 (05) 283-290
    CrossrefPubMedGoogle Scholar
  • 7 Varma S, Bartlett EL, Nam L, Shores DR. Use of breast milk and other feeding practices following gastrointestinal surgery in infants. J Pediatr Gastroenterol Nutr 2019; 68 (02) 264-271
    CrossrefPubMedGoogle Scholar
  • 8 Baerg JE, Munoz AN. Long term complications and outcomes in omphalocele. Semin Pediatr Surg 2019; 28 (02) 118-121
    CrossrefPubMedGoogle Scholar
  • 9 Bhat V, Moront M, Bhandari V. Gastroschisis: a state-of-the-art review. Children (Basel) 2020; 7 (12) 7
    PubMedGoogle Scholar
  • 10 Hong CR, Zurakowski D, Fullerton BS, Ariagno K, Jaksic T, Mehta NM. Nutrition delivery and growth outcomes in infants with gastroschisis. JPEN J Parenter Enteral Nutr 2018; 42 (05) 913-919
    CrossrefPubMedGoogle Scholar
  • 11 Fitzgerald DA, Kench A, Hatton L, Karpelowsky J. Strategies for improving early nutritional outcomes in children with oesophageal atresia and congenital diaphragmatic hernia. Paediatr Respir Rev 2018; 25: 25-29
    PubMedGoogle Scholar
  • 12 Salvatori G, Foligno S, Occasi F. et al. Human milk and breastfeeding in surgical infants. Breastfeed Med 2014; 9 (10) 491-493
    CrossrefPubMedGoogle Scholar
  • 13 Hennet T, Borsig L. Breastfed at Tiffany's. Trends Biochem Sci 2016; 41 (06) 508-518
    CrossrefPubMedGoogle Scholar
  • 14 World Health Organization. World Health Organization. Guideline: Assessing and Managing Children at Primary Health-Care Facilities to Prevent Overweight and Obesity in the Context of the Double Burden of Malnutrition: Updates for the Integrated Management of Childhood Illness (IMCI) Web site. Accessed January 18, 2022, at: https://www.who.int/publications/i/item/9789241550123
    PubMed
  • 15 Nilsson I, Busck-Rasmussen M. Amning - en håndbog for sundhedspersonale. 5th ed. København: Sundhedsstyrelsen; 2021
    Google Scholar
  • 16 Bruun S, Buhl S, Husby S. et al. Breastfeeding, infant formula, and introduction to complementary foods-comparing data obtained by questionnaires and health visitors' reports to weekly short message service text messages. Breastfeed Med 2017; 12 (09) 554-560
    CrossrefPubMedGoogle Scholar
  • 17 Maastrup R, Hansen BM, Kronborg H. et al. Breastfeeding progression in preterm infants is influenced by factors in infants, mothers and clinical practice: the results of a national cohort study with high breastfeeding initiation rates. PLoS One 2014; 9 (09) e108208
    CrossrefPubMedGoogle Scholar
  • 18 Riddle S, Haberman B, Miquel-Verges F. et al. Gastroschisis with intestinal atresia leads to longer hospitalization and poor feeding outcomes. J Perinatol 2022; 42 (02) 254-259
    CrossrefPubMedGoogle Scholar
  • 19 Salvatori G, Foligno S, Massoud M, Piersigilli F, Bagolan P, Dotta A. The experience of breastfeeding infants affected by congenital diaphragmatic hernia or esophageal atresia. Ital J Pediatr 2018; 44 (01) 75
    CrossrefPubMedGoogle Scholar
  • 20 Tucker A, Huang EY, Peredo J, Weems MF. Pilot study of sham feeding in postoperative neonates. Am J Perinatol 2022; 39 (07) 726-731
    Article in Thieme ConnectPubMedGoogle Scholar
  • 21 Kyhl HB, Jensen TK, Barington T. et al. The Odense Child Cohort: aims, design, and cohort profile. Paediatr Perinat Epidemiol 2015; 29 (03) 250-258
    CrossrefPubMedGoogle Scholar
  • 22 Lee PA, Chernausek SD, Hokken-Koelega AC, Czernichow P. International Small for Gestational Age Advisory Board. International Small for Gestational Age Advisory Board consensus development conference statement: management of short children born small for gestational age, April 24-October 1, 2001. Pediatrics 2003; 111 (6 Pt 1): 1253-1261
    CrossrefPubMedGoogle Scholar
  • 23 Niklasson A, Albertsson-Wikland K. Continuous growth reference from 24th week of gestation to 24 months by gender. BMC Pediatr 2008; 8: 8
    CrossrefPubMedGoogle Scholar
  • 24 Hijkoop A, Peters NCJ, Lechner RL. et al. Omphalocele: from diagnosis to growth and development at 2 years of age. Arch Dis Child Fetal Neonatal Ed 2019; 104 (01) F18-F23
    CrossrefPubMedGoogle Scholar
  • 25 Moro GE, Arslanoglu S, Bertino E. et al; American Academy of Pediatrics; European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. XII. Human milk in feeding premature infants: consensus statement. J Pediatr Gastroenterol Nutr 2015; 61 (Suppl 1): S16-S19
    CrossrefPubMedGoogle Scholar
  • 26 Leibovitch L, Zohar I, Maayan-Mazger A, Mazkereth R, Strauss T, Bilik R. Infants born with esophageal atresia with or without tracheo-esophageal fistula: short- and long-term outcomes. Isr Med Assoc J 2018; 20 (03) 161-166
    PubMedGoogle Scholar
  • 27 Tenovuo A, Kero P, Piekkala P, Korvenranta H, Sillanpää M, Erkkola R. Growth of 519 small for gestational age infants during the first two years of life. Acta Paediatr Scand 1987; 76 (04) 636-646
    CrossrefPubMedGoogle Scholar
  • 28 Minutillo C, Rao SC, Pirie S, McMichael J, Dickinson JE. Growth and developmental outcomes of infants with gastroschisis at one year of age: a retrospective study. J Pediatr Surg 2013; 48 (08) 1688-1696
    CrossrefPubMedGoogle Scholar
  • 29 Pelizzo G, Destro F, Selvaggio GGO. et al. Esophageal atresia: nutritional status and energy metabolism to maximize growth outcome. Children (Basel) 2020; 7 (11) 7
    PubMedGoogle Scholar
  • 30 Mason SJ, Harris G, Blissett J. Tube feeding in infancy: implications for the development of normal eating and drinking skills. Dysphagia 2005; 20 (01) 46-61
    CrossrefPubMedGoogle Scholar
  • 31 Vergouwe FWT, Spoel M, van Beelen NWG. et al. Longitudinal evaluation of growth in oesophageal atresia patients up to 12 years. Arch Dis Child Fetal Neonatal Ed 2017; 102 (05) F417-F422
    CrossrefPubMedGoogle Scholar
  • 32 Gulack BC, Laughon MM, Clark RH. et al. Enteral feeding with human milk decreases time to discharge in infants following gastroschisis repair. J Pediatr 2016; 170: 85-89
    CrossrefPubMedGoogle Scholar