Lavado gástrico en recién nacidos sanos: un ensayo clínico aleatorio

INTRODUCTION: Gastric lavage is still used in Mexico and other countries without evidence to support this practice. We performed a randomized controlled trial to test the hypothesis that elimination of amniotic fluid from the stomach of the newborn reduces nausea and vomiting and improves tolerance on the first feedings of breast or formula milk. PATIENTS AND METHODS: A randomized, single-blind, controlled trial was conducted in a rural general hospital in the north of Mexico. Eligible healthy term newborns were randomly allocated to receive gastric lavage (n = 63) or observation (n = 61). The primary outcome measures were the presence of nausea and/or emesis in the first 24 hours of life and the breastfeeding failure rate, evaluated by a nurse blinded to the group assignment. RESULTS: Of the 63 patients in the gastric lavage group, 13 had at least one episode of nausea or vomiting compared with 15 out of 61 patients in the control group (relative risk: 0.84; 95 % CI: 0.43 to 1.61). Breastfeeding failure occurred in seven mother-child pairs in the gastric lavage group compared with five in the control group (P = 0.8; relative risk: 0.96; 95 % CI: 0.86 to 1.08). Other variables such as sex or cesarian section rate were unrelated to outcome. There were no complications that could be attributed to the procedure. All the newborn infants were discharged without problems. CONCLUSIONS: Gastric aspiration or lavage in the healthy full-term newborn is a common procedure that should be abandoned as it confers no advantages.