Department of Pediatric, PICU Dr.Sheikh Hospital, Mashhad University of Medical Science (MUMS), Mashhad, Iran.
Department of Pediatric, Mashhad University of Medical Science(MUMS), Mashhad, Iran.
Infants born with congenital anomalies demand individualized nutritional evaluations and recommendations. The anatomical changes of neonatal surgical diseases create specific physiological constraints.Patients with different congenital anomalies have different nutritional support needs. It is essential to know the exact physiology of these anomalies in order to be able to manage and provide them with appropriate and suitable nutritional supports. This article reviews several nutrition-centered options to aid the medical provider caring for babies with common surgical diseases.
Method and Materials:
Medline searches were performed using the keywords congenital anomalies, gastroesophageal reflux, motility, nutrition and the text word nutrition in congenital GI anomalies . Bibliographies of recent review articles and relevant primary research reports, as well as Current Contents of ASPEN, ESPEGHAN guidelines were reviewed for additional relevant citations. This article describes the nutritional needs of infants with congenital anomalies that require surgical repair or palliation. It is limited to several commonly encountered surgical diseases of infants:
• Foregut and midgut anomalies (esophageal atresia / tracheoesophageal fistula, intestinal atresia, malrotation)
• Pulmonary hypoplasia: congenital diaphragmatic hernia (CDH) and lung malformations
• Abdominal wall defects (giant omphalocele, gastroschisis)
• Diseases treated with enterostomy (eg, Hirschsprung’s disease [HD], imperforate anus
Infants born with congenital anomalies demand individualized nutritional evaluations and recommendations. Just within general and thoracic pediatric surgery, diseases include congenital anomalies in the infant, common acquired conditions such as pyloric stenosis and necrotizing enterocolitis, trauma, feeding tube placement, and organ transplantation. With the exception of the surgical repair itself, few interventions hold greater power to alter the outcome of these problems than attention to nutrition. To successfully support these patients, the dietitian must understand not only the essential details of these diseases but also the particular ways that the diseases and their surgical treatments impose demands and constraints on nutritional support. Nutritional challenges commonly include delayed oral feeding, GER, dysmotility of the distal esophagus and strictures each of which needs different kind of support and management will be discussed specifically in this article.
Keywords: Congenital Anomalies, Gastroesophageal Reflux, Motility, Nutrition.