#Trophic_feeding or #minimal_entral_feeding"MEF"
It is the administration of small enteral feeds less than 24 mL/kg/day to promote postnatal gastrointestinal maturation and reduce mucosal atrophy.
It has the potential for protective effects against development of nosocomial infections and necrotizing enterocolitis.
It provides stimulation for gut growth.
Initiate enteral nutrition for all infants as soon as possible or within 6 hours of birth unless there are contraindications to feeding (i.e. known gastrointestinal anomaly or obstruction).
Continue MEF even if following occur:
Umbilical catheters. ï‚· Intrauterine growth restriction. ï‚· Inotropic or nitric oxide support. ï‚· In utero reversal of end-diastolic flow. ï‚·
Decreased bowel gas seen on an abdominal x-ray. ï‚·
Treatment for Patent Ductus Arteriosus (PDA).
Discontinue or delay MEF if any of the following occur: ï‚·
Infant is receiving two or more inotropes. ï‚·
Infant has a serum lactate of greater than or equal to 3 mmol/litre (after 24 hours of age) ï‚·
(لان الØاجتين دول معناهم hemodynamic instability)
Infant is diagnosed with Necrotizing Enterocolitis (NEC) ï‚·
Infant has suspected or confirmed bowel obstruction.
Note: Unless NEC or bowel obstruction confirmed, continue to assess at routine times and restart MEF as soon as possible.