Gastric emptying at birth - good or bad practise?

[mirkspac]

Gastric empying at birth: good or bad practice?
My opinion is that it is equivalent to throw away the first reserve of feed.
Mirko Spacapan
NICU Udine ITALY

[Alexander Rakow]

Dear Mirko,
to my opinion there is no general need in doing so, i consider the trauma by unneccesary suction higher than the theoretical benefit of it. You might just get vagal stimulation.
Our practice at the Karolinska Hospital is no suction if there is no special need for it.
Alexander Rakow
Karolinska Hospital
Dep. of Neonataology

[manberbenitez]

Dear Mirko:
Here in Mexico, there is a routine to make a gastric lavage at born,personally I think there is no reason to do it, some neonates that swallowed a regular amount of maternal blood, probably have some intolerance feeding at the begining, but are very few, so in general I consider that this practice have no reason to do it

[Liliroom]

Hello ,I am a NICU RN working a neonatologist that use only the bulb suction
so most of the babies are having trouble feeding or need gastric lavage.
I n my opinion if the first suction was done deeply so no need for routine gastric lavage.
RN-NICU

[manuel perez valdez]

hi,
in Guatemala, at Roosevelt Hospital specialy, there is a routine to make a gastric lavage at born, because you can made the diagnosis esophageal atresia, duodenale atresia, coanal nasal atresia.

[kpsanghvi]

No need unless the infant is vomiting whether there is MSL or not.

Regards

K P Sanghvi

[musara]

no need unless the baby is vomiting

[DrZeeshan Ahmed]

In our unit at naval hosp Karachi Pakistan,we only do gastric lavage if baby is vomiting repeatedly or has coffee ground aspirate but not as a routine.I consider routine lavages as unneccessary and could potentially lead to vagal stimulation.

[sbarak]

We are doing gastric lavage only when we know about bloody amniotic fluid and the baby is at risk of aspirating the bloody amniotic fluid.
I think ,routinly it's not needed ,because it can make vagal stimulation.Don' foget even more serious complication such as perforation.

[Mariam]

gastric lavage should not be done as a routine care. The newborn usually will tell you if he is gonna need one...

[hehady]

In our unit routine gastric suction is not recommended. However if there is MSAF we do recommend it.

Please look at the following related refernces:

Anand KJS, Runeson B, Jacobson B. Gastric suction at birth associated
with long-term risk for functional intestinal disorders in later life. J Pediatr
2004;144:449-54.

Conklin LS, Perlman JM, Wyckoff MH. Gastric suction at birth.
J Pediatr. 2005 Jan;146(1):152-3; author reply 153.

nand KJ, Jacobson B, Hall RW. Gastric suction at birth: not an innocent bystander.J Pediatr. 2004 Nov;145(5):714;

Di Lorenzo C, Saps M. Gastric suction in newborns: guilty as charged or innocent bystander? J Pediatr. 2004 Apr;144(4):417-20.

Regards

[doc4tots]

Many will claim that this procedure is needed to clear blood and mucus so as to prevent vomiting/aspiration. The risk of the procedure includes bradycardia, trauma, and removing what is, the infant's first meal. We do not do this in our NICU.

[pooperscooperrn0624]

Routing suctioning isn't necessary in most cases. We insert og tubes to open drain for decompressiong and only suction if infant is spitting and choking on mucous or swallowed blood.

[bbmt]

Hi all,

What is your opinion about gastric scution after meconium aspiration. Is it a good parctice or do they have different views. We have found decreased frequency of vomiting or feeding problems after suctioning.

BBMT

[MakharadzeGivi]

Our practice at the NMC of Georgia perinatal centre is no suction if there is no special need for it.

[162761]

I believe Drs. Narchi and Kulaylat published a study where they showed that this practice is not necessary.
Narchi H, Kulaylat N.Is gastric lavage needed in neonates with meconium-stained amniotic fluid? Eur J Pediatr. 1999 Apr;158(4):315-7.

Velaphi S, Vidyasagar D. Intrapartum and postdelivery management of infants born to mothers with meconium-stained amniotic fluid: evidence-based recommendations.Clin Perinatol. 2006 Mar;33(1):29-42, v-vi. Review.

Oussama Itani, MD;FAAP;FACN
Clinical Associate Professor of Pediatrics and Human Development- Michigan State University & Kalamazoo Center for Medical Studies
Director of Neonatology
Borgess Medical Center
1521 Gull Road
Kalamazoo, MI 49048
Phone: (269)-226-5778
Fax: (269)-226-5998
email: oussama@pol.net

[fiona]

infant dictates if gastric lavage is necessary

[rajmed]

No doubt it's bad. How can we welcome some one to this world by putting a plastic tube in his mouth or nose when it's not indicated. I think it's more dangerous and harmful than beneficial. Most of the normal deliveries which are not attainded by qualified medical practitioners, nothing is done in such babies. These babies are given straight way to mother for feeding and they go home after three day.

[Kumarsand]

In our hospital we routinely do gastric lavage in those newborn who need NICU admission because most of them are sick and there are chances of aspiration. Also it rule out choanal atresia,TEF and esophageal atresia. However we do not do this in well newborns.

[drprasadrao]

Routine gastric lavage is unnecessary we do it only in case of ceasarean sections where there is thick pasty meconium to prevent aspiration after regurgitation. Do you do the same? Or some of us believe in generalisation & not sure of preventive medicine?

[devinder chopra]

It is a very good practise and I have done it for over 30 yrs.

It not only empties the stomach but helps you pickup oesophageal atresia and upper GI obstruction right at birth.

Gastric aspirates of >20-25 ml are highly suggestive on upper GI obstruction

[SAEED ABDELAATY MABROUK]

OF COURSE ,IT'S NOT A ROUTINE,ONLY ON ANTICIPATING EA OR TEF IN CASE OF POLY- HYDRAMNIOS,OR IN THICK MECONIUM OR IN TOO MUCH SWAALLOWED MATERNAL BLOOD& FOR GASTRIC DECOMPRESSION IN SOME CASES LIKE CDH