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preterm baby with green aspirate


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preterm baby his BW is 1000g, enter nicu for gaining wt firstly brown aspirate with trophic feeding then start greenish aspirate and dealed as NEC , so NPO for 1 w without stopping of greenish aspirate reach till 15 ml/day, so gastrograffin study was done and revealed free study and baby pass motion in spite green aspirate so i start with him erythromycin as pro-kinetic drug for 1 w and stop and start feeding again very slowly and now he tolerate 3cc/kg every 3h with no residual now what is your opinion in this case , what is possible diagnosis????

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First of all there is no need to keep on looking residuals when you start feeding the preterms unless there are other signs like abdominal distension which is more definitive indication of possible NEC. Tube in duodenum or in lower area can result in greenish aspirates. Feeding itself has certain pro kinetic effects.

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Guest cocoguawa

Did you measure the gastric pH? One of the multiples sign of estress is the feeding intolerance, and the low gastirc pH. Pain or overstimulation could be the cause. In this case the resolution of the case is easy... don´t disturb!! :-D
Last week I found a gastric aspirate green coloured (brilliant green) the pH was 1-2!! The doctor prescribed ranitidine for gastric protection.

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