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

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

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

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

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.

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

Regards

K P Sanghvi

no need unless the baby is vomiting

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.

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.

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

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

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.

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

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

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

infant dictates if gastric lavage is necessary

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.

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.

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?

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

Edited September 30, 200817 yr by devinder chopra
required by your system

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

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?

Gastric emptying is not required at birth.The reason we put a tube in is to rule out TOF but we dont lavage the contents.The calories in Gastric aspirate work as initial energy for the newborn.If baby cries well at birth no need to do even suction.