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November 2018

Need for Reassessment of Early Transpyloric Feeding in Preterm Infants

Author Affiliations
  • 1Division of Neonatal and Developmental Medicine, Department of Pediatrics, School of Medicine, Stanford University, Palo Alto, California
JAMA Pediatr. 2018;172(11):1004-1005. doi:10.1001/jamapediatrics.2018.2035

Over the past several decades, strategies aimed at eliminating sources of lung injury have changed the practice of neonatology and improved survival rates for the smallest newborns. However, pulmonary aspiration—a well-recognized source of lung injury—continues unabated among neonates today. Herein, we describe the rationale for reevaluating the bygone practice of early transpyloric feeding for preterm infants, a topic that has not been rigorously studied since the 1980s.1 We contend that (1) aspiration is ubiquitous among preterm infants, (2) aspiration probably contributes to the development of bronchopulmonary dysplasia (BPD), (3) transpyloric feeding reduces the risk of aspiration, and (4) transpyloric feeding is probably safe in preterm infants.

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