• GASTROCHISIS AND NUTRITIONAL MANAGEMENT II

My last post:ÂGASTROCHISIS AND NUTRITIONAL MANAGEMENT I

Continuing on the Nutritional management of gastrochisis after introducing the Total parenteral nutrition, then there is gradual introduction of enteral feeding. Gradually introduce enteral feeding once the bowel activity improves.

How do I know when to introduce enteral feeding? The following signs to know when to gradually introduce feeding are;

• Presence of bowel sounds
• Reduced gastric drainage
• Passage of stool
• Reduced abdominal distension

Also, breastmilk which is considered the optimal choice of feeding because;

1. It digest easily
2. It promotes the healing of the intestines
3. It enhance immunity
4. Reduces the risk of infection
5. Also improves feeding tolerance

Another choice of milk when the maternal milk is unavailable is the donor human milk or rge specialized infant formulas. They can be used as substitute for the maternal milk. The volume of feeding are increased gradually while monitoring vomiting, abdominal swelling, gastric residuals,stool output and weight gain. Many babies require several attempts before they can eventually tolerate full feeds.

 

You can also read on : TYPE 2 DIABETES

LONG TERM NUTRITIONAL MANAGEMENT

Some babies with complex gastrochisis may need high calorie feeds, fortified breast milk,Nasogastric tube feeding,prolonged Total parenteral nutrition (TPN) and vitamin and mineral supplementation. In this case nutritional plan is individualized and supervised by a neonatal amd pediatric dietitian.

Overall, there should be ;

• Adequate energy intake to support growth
• Sufficient protein for tissue repair
• Proper hydration to replace fluid losses
• Micronutrient provision to prevent deficiencies
• Gradual enteral feeding to restore the function of the bowel
• And growth monitoring to ensure normal development.

With a good morden neonatal surgery and a well planned nutritional support there is high chance of survival, achievement of full enteral feeding and improvement in growth once feeding tolerance is established.

Also check:ÂDIETARY MANAGEMENT OF LIVER DISEASEÂ

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