Saline Enema versus No Enema to Promote Enteral Feeding in Preterm Infants: A Randomized Controlled Trial

Establishment of enteral nutrition is a significant challenge for premature infants in the neonatal intensive care unit. It is mainly due to delayed gastric emptying, uncoordinated forward propulsive mechanism and increased susceptibility of the gastrointestinal neuronal system to noxious stimulus such as sepsis, acidosis or hypoxia leading to disruption in control of peristalsis. This leads to development of feed intolerance and delay in establishing adequate enteral feeds. Various strategies have been tried to improve feed intolerance which include trophic feeds, use of prokinetics, early meconium evacuation. Our study has an objective of comparing the efficacy of saline enema versus no enema for early meconium evacuation in preterm very low birth weight infants on time to achieve full enteral feeds.