Gastric Retention in Neonates

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Abstract
Forty-seven healthy neonates were fed by nasogastric tube 10 to 20 ml/kg of 5-gm/dl glucose in water containing 0.24 mg/dl of phenol red as a marker. The proportion of test meal remaining in the stomach 30 minutes after feeding was measured. Gestational ages ranged from 34 to 44 weeks and birth weights ranged from 1,300 to 4,680 gm. Thirteen of 29 term neonates were appropriate for gestational age (AGA), six were small for gestational age (SGA), and nine were large for gestational age (LGA). Of the 18 preterm neonates, 6 were AGA and 12 were SGA. Each baby was studied three times: at 4 to 12 hours after birth, before any other feeding, at 22 to 36 hours, and at 46 to 60 hours. Preterm AGA babies retained more than term AGA neonates at both 4 to 12 hours and 22 to 36 hours. Preterm SGA neonates retained more than their term peers at 4 to 12 hours only. In both term and preterm neonates, 30 minute gastric retention decreased significantly from the 4- to 12-hour period to the 22- to 36-hour period, but it was similar at 22 to 36 hours and 46 to 60 hours. At no time were there significant differences in retention between AGA, SGA, and LGA babies-except at 22 to 36 hours when preterm SGA neonates retained less than their AGA peers. Thus 30-minute gastric retention was affected mainly by gestational maturity and postnatal age rather than by the quality of intrauterine growth.