Korean J Perinatol.  2015 Mar;26(1):46-52. 10.14734/kjp.2015.26.1.46.

Comparison of Enteral Feeding in Early Neonatal Period in Very Low Birthweight Infants with Hypothyroidism

Affiliations
  • 1Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea. revival421@gmail.com
  • 2Department of Pediatrics, Korea University College of Medicine, Seoul, Korea.

Abstract

PURPOSE
We investigated the effects of hypothyroidism on feeding advancement in very low birth weight infants (VLBW).
METHODS
This study was a retrospective case-control study of 14 very low birth weight infants (VLBWIs) diagnosed with hypothyroidism and other 14 infants were recruited as age- and weight-matched controls without hypothyroidism or hypothyroxinemia in Seoul National University Children's Hospital between January 2007 and August 2009. We examined whether these infants gained weight more, achieved full-volume enteral feedings sooner, had fewer episodes of increased pre-gavage residuals, and had fewer days of parenteral nutrition.
RESULTS
Until full enteral feeding (120 mL/kg/day) was not statistically significant between the groups. In the hypothyroidism group, during the first 14 days after birth, the volume of feeding was smaller [14.7 (0.5-84.0) mL/kg/day, P=0.041], the episodes of increased pre-gavage residuals were frequently observed [16.7 (0.2-78) times, P=0.036], and the duration of central line was significantly longer [18 (10-50) days, P=0.018]. In hypothyroidism group, mean day at first L-thyroxine supplementation was 24.2+/-10.2 days after birth. L-thyroxine administration boosted thyroid function for hypothyroidism infants, helped them tolerate a larger amount of enteral feeding [from 89.5 (2.9-160.8) to 146.9 (31.8-178.8) mL/kg/day, P=0.002] and decreased episodes of excessive gastric residuals [from 5.5 (0-41.6) to 0 (0-44) time, P=0.026]. However, no more weight gain was statistically found.
CONCLUSION
In VLBW infants, hypothyroidism may induce feeding intolerance. L-thyroxine supplementation was effective in feeding advancement on preterm infants with hypothyroidism.

Keyword

Very low birth weight infant; Premature infant; Hypothyroidism; Enteral feeding

MeSH Terms

Case-Control Studies
Enteral Nutrition*
Humans
Hypothyroidism*
Infant*
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight
Parenteral Nutrition
Parturition
Retrospective Studies
Seoul
Thyroid Gland
Thyroxine
Weight Gain
Thyroxine

Figure

  • Fig. 1. Comparison of feeding volumes (A) and episodes of residues per day during 14 days after birth (B) between the hypothyroidism group and control group.

  • Fig. 2. In hypothyroidism infants, comparison of episodes of gastric residues per day between 2 weeks before and after L-thyroxine administration, respectively. They showed fewer episodes of residue per day after L-thyroxine administration (P=0.01). In control group, “day 0” means the 24 days after birth which is the mean day of L-thyroxine administration for hypothyroidism infants.


Reference

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