Feeding and Growth after Closure of Abdominal Wall Defects: Omphalocele and Gastroschisis (8 of 11)

Once an infant has an abdominal wall closure, the next step is to introduce feeds as the intestine recovers. http://fetalsurgery.chop.edu

Experts from Center for Fetal Diagnosis and Treatment at Children’s Hospital of Philadelphia explain the process for initiating and advancing feeds after closure of abdominal wall defects, such as gastroschisis and omphalocele.

After gastroschisis repair, it takes time for the intestine to recover and function normally. For this reason, first feedings are provided through an intravenous (IV) line. Once intestinal function returns, oral feedings or feedings via an NG tube are slowly started while IV feeds continue.

Pumping and freezing of breast milk is encouraged for feeding babies with abdominal wall defects, because a mother's milk is particularly beneficial for infants with special medical needs. Oral feedings are slowly increased. This is a gradual process. Close attention will be paid to the condition of the intestine and your baby’s growth.

Infants with abdominal wall defects, especially giant omphalocele, are at risk for having a lot of trouble with gastroesophageal reflux. For babies who don’t respond to medical therapy for reflux, they may have a surgery called fundoplication, which creates a one-way valve to present the reflux and make it more difficult for reflux to occur.

Babies with gastroschisis are also at risk for late necrotizing enterocolitis, a serious bowel infection, which can be treated with bowel rest and IV antibiotics.