680 - Assessing Predictors and Protocol for Home Enteral Feeding Devices in Infants Treated with Therapeutic Hypothermia

Publication Number: 680.3742

Swathi U. Ariyapadi, CHOC Children's Hospital of Orange County, Irvine, CA, United States; Nicole H. Cobo, MemorialCare Miller Children’s & Women’s Hospital, Long Beach, CA, United States; nam Nguyen, Keck of USC School of Medicine, Los Angeles, CA, United States; Shawna Townsend, Miller Children's & Women's Hospital Long Beach, Lomita, CA, United States; Tiffany Salazar, Miller Children's & Women's Hospital Long Beach, Long Beach, CA, United States; Steve Y. Cho, Miller Children's & Women's Hospital Long Beach, Long Beach, CA, United States; Ching Ching Tay, MemorialCare Miller Children's & Women's Hospital, Cypress, CA, United States; Antoine Soliman, Miller Children's & Women's Hospital Long Beach, Long Beach, CA, United States; Alexandra Iacob, MemorialCare Miller Children's & Women's Hospital Long Beach, Long Beach, CA, United States

Background: Many infants affected by hypoxic ischemic encephalopathy (HIE) have feeding intolerance and require home enteral feeding devices. Little is known about predictors for enteral feeding tube needs in this population, and about the appropriate timeline for initiation of feeding tube discussion and intervention.

Objective: Identify predictors of need for enteral feeding devices at discharge for infants treated with therapeutic hypothermia (TH) for encephalopathy.

Design/Methods: This single-center retrospective study included infants admitted between 2018-2024, birth gestational age >= 36 wks gestation who underwent TH for presumed ischemic injury. IRB approval obtained. Data collection included demographics, perinatal history, maternal medical history, and feeding progression and needs throughout hospitalization. The focus of this study is to identify associations between singular or composite peri- and post-natal variables and enteral feeding progression for infants treated with TH. T-test and chi squared testing were used to evaluate differences between continuous and categorical variables.

Results: 90 infants were treated with TH and after excluding infants below 36 weeks gestational age, transferred out, deaths, and other genetic/anatomic anomalies impeding feeding, 61 infants were included in full analysis. 11 infants required a feeding device on discharge. There were no significant differences between demographic variables in infants who required enteral feeding devices and those who did not. EEG tracing in the first 24 hours, MRI findings, and ability to nipple 50% by 2 weeks of life were the only factors statistically significant between the two groups. Conversations regarding enteral device needs averaged at 43.4 weeks gestation. Enteral feeding tube placement occurred at 45.3 weeks corrected age on average. Process measures showed no statistical difference of timing of physical therapy and occupational therapy involvement, with a slight delay in lactation involvement in the group requiring feeding device at discharge.

Conclusion(s): Abnormal MRI reads, severity of EEG findings in the first 24 hours and inability to nipple 50% of feeds within the first 2 weeks of life were statistically significant risk factors among infants receiving TH who needed a feeding device at time of discharge. There was no significant association between delivery room variables. The limitations of this study include small sample size and variability in practice. Data collected and analyzed in this study will be used to direct quality improvement work in feeding practices for these infants.

Comparison of Demographic Variables Between Infants Discharged With and Without Enteral Feeding Devices


Comparison of Post-natal Evaluation for Infants Discharged With and Without Enteral Feeding Devices


Comparison of Feeding Therapies and Interventions in Infants Discharged With and Without Enteral Feeding Devices