Enteral feeding practices among infants with gastroschisis in Canada: a national cohort study

Purpose To describe enteral feeding practices and clinical outcomes among infants with gastroschisis at neonatal intensive care units (NICUs) in Canada. Methods Infants with gastroschisis were identified using data from the Canadian Neonatal Network and Canadian Pediatric Surgery Network. These included patients with (1) mild or no matting, (2) severe matting, and (3) complex gastroschisis (i.e., presence of intestinal necrosis, perforation, and/or atresia). We explored patterns of enteral feeding and associated clinical outcomes during the NICU admission. Results We identified 348 infants with gastroschisis: 297 had mild or no matting, 24 had severe matting, and 27 had complex gastroschisis. During the NICU admission, 64% received exclusive human milk (i.e., mother’s own milk, human donor milk, or both) and 36% received one or more days of formula. There were no differences between infants with mild or no matting, severe matting, or complex disease in terms of use to formula (36% vs 33% vs 44%, p=0.63) or donor milk (19% vs 17% vs 22%, p=0.87). Exclusive human milk use at the time of discharge from NICU was high across all groups (79% vs 86% vs 86%, p=0.62). The frequency of donor milk use increased from 5% in 2015 to 31% in 2023 (p<0.001). Conclusion We conclude that most infants with gastroschisis in Canada receive exclusive human milk during their NICU admission. The remainder receive one or more days of formula, but most patients transition to exclusive human milk by the time of NICU discharge. The use of donor human milk is increasing. LEVEL OF EVIDENCE Level IIb (Individual Cohort Study)