Abstract:OBJECTIVE: Recurrent apnoea and bradycardia are common in extremely low birth weight (ELBW) infants, especially in the babies who suffered from chronic lung disease (CLD). Gasrtroesophageal reflux (GOR) is believed to be responsible for recurrent apnoea and bradycardia. The aim of the study was to evaluate the effects of transpyloric feeding on the frequency of apnea and bradycardia episodes in infants who had suspected GOR. METHODS: Clinical data of 81 ELBW infants were retrospectively reviewed. In those who received transpyloric feeding (TP group, n=30), the frequency of apnoea and bradycardia episodes, feeding tolerance, nutritional intake, and weight gain were recorded before and during transpyloric feeding and were compared to those who received intermittent intragastric feeding (IG group, n=49). The complications related to feeding were observed in the two groups. RESULTS: In the TP group, the number of apnoea episodes (from 1.64 to 0.66; P< 0.05) and bradycardia (B1 from 3.32 to 2.06 and B2 from 3.18 to 1.66; both P< 0.05) per day decreased significantly, and vomiting and abdominal distension did not recur after the commencement of transpyloric feeding. There were no significant differences in protein and energy intakes before and during transpyloric feeding, but the rate of weight gain per day during transpyloric feeding was significantly lower than that before transpyloric feeding (from 15.3 g/kg to 13.3 g/kg; P< 0.05). Protein and energy intakes and weight gain were the same for the two groups. Necrotising enterocolitis and duodenal perforation did not occur in the TP group. CONCLUSIONS: Transpyloric feeding may significantly reduce the frequency of apnoea and bradycardia episodes and improve feeding tolerance in the ELBW infants who are unable to tolerate intragastric feeding.
