Pilot Study of Sham Feeding in Postoperative Neonates.

OBJECTIVE: Sham feeding may enhance development of oral skills in neonates after bowel surgery and decrease stress levels in mothers. In this pilot study, we test the feasibility of sham feeding, identify safety hazards, and assess maternal satisfaction. STUDY DESIGN: A convenience sample of 15 postoperative neonates was enrolled. Sham feeding with unfortified human milk was offered following a strict advancement protocol beginning with 5 mL once daily and increasing up to 30 mL, three times daily. Continuous gastric suction was used during sham feeding. Each mother completed a satisfaction survey. Sham-fed gastroschisis patients were compared with a historic cohort. RESULTS: All 15 patients were able to sham feed. A total of 312 sham feeds were offered with a median of 23 sham events per patient. Four minor complications occurred during sham feeding. No differences were noted between 11 sham-fed gastroschisis patients and 81 historic controls. The mothers reported a decrease in stress after sham feeding using a 5-point score (3.8 ± 1.4 vs. 1.5 ± 0.7, p < 0.005) and 100% satisfaction with sham feeding. CONCLUSION: Sham feeding is feasible for neonates after bowel surgery and is highly rated by mothers. KEY POINTS: · Sham-feeding human milk to neonates after bowel surgery is feasible and safe.. · A novel postoperative sham feeding protocol is described.. · Mothers of sham-fed infants report it reduces stress compared with not feeding..

Comparative case studies: PDAs treated with medication, surgical ligation, and transcatheter device closure.

The ductus arteriosus is a lifeline for the developing fetus prior to delivery, allowing the circulation of oxygen-rich blood from the placenta to bypass the lungs and perfuse the body. However, when the ductus fails to close after birth, the pressures can cause blood to shunt from the aorta back into the lungs, causing pulmonary edema. This is called a left-to-right shunt. The patent ductus arteriosus (PDA) can also shunt blood from the pulmonary arteries to the aorta, bypassing the lungs and causing oxygen-poor blood to mix with the oxygen-rich blood circulating to the body. This is called a right-to-left shunt. Too much shunting in either direction can cause significant long-term problems for the neonate. These three case studies compare the outcomes of patients with PDAs closed using different treatment techniques. The first patient's ductus arteriosus closed >2 months after birth following pharmacologic treatment. The second was closed by surgical ligation. The third was closed by transcatheter device closure.