Glucose before enteral feeding?

[shiwenxia]

Here is a question to everyone , in china there is a habit in clinics, when we prepare to feed a pretern infant first time, we usually use 5% glucose 2 times before milk, how do you think about it? is there any evidence? thank you !

[holliesmama]

Hmm, interesting but Why?

[shiwenxia]

hi ,holiesmama:

this is traditional method, the teacher's simple explanation is to prevent GER, but i did't find any evidence about it, you know,it is an evidence medicine era.

[mbayari]

Hi dear
Almost Moroccan pediatricians have the same habit but not the same goal: they try to prevent early hypoglycemia. To my knowledge, there is no study confirming the benefits of such an attitude. Several authors demonstrated that giving 5% or 10% dextrose is accompanied by a delayed normal increasing glycemia (which happens 1-1,5h after birth). Early hypoglucemia is actually known to be transient and warrant no special managment.

[Alexander Rakow]

I fully agree, as long as there are no speciell risk factors there is no need for administration of dextrose. As you mentioned, early hypoglycemia is transient and fysiological.
In preterm , SGA or infants born to mothers with diabetes we usally try to prevent hypoglycemia by early feedings.

[alaiyan]

It is an old practice and not based on any evidence. Some pediatricians believe that in case of aspiration glucose has less damage to lungs, but in fact is not and this is based on a study that showed there was no difference in affecting lungs between milk and glucose. So I usually start babies on milk and I found no problems. Some of our pediatric surgeons like to start with glucose in post OP babies but again this is not based on any evidence.

[hehady]

Breast feeding is the best for initial feedings (evidence based). Oral glucose increases feeding intolerance and aspiration (personal experience)

[lbgorstj]

I agree that it isnt any need to do that if the child dont need it.
In preterm , SGA or infants born to mothers with diabetes we usally try to prevent hypoglycemia by early feedings.If we can we use BM, we use glucose when we do practical procedures as blood sampling.

[drhassan.nimer@gmail.com]

Dear colleague, 5% glucose or destilated water 1-2 cc may show the easy process of swelling,with less stepen of aspiration if it is possible and less causes GER. There for no risk factors to give a small amount of water or glucose, oespecially if immideately followed by milk

Thanks