Objective To evaluate the correlation between development of a mature bowel habit, early feeding tolerance and growth.
Materials and Methods All infants with a gestational age ⩽28 weeks, born in our hospital between August 2006 and September 2007 (n = 70), were included. Patients were fed following a standardised protocol. Enemas or rectal stimulation were administered when abdominal distension and no defecation within the previous 24 h occurred. Achievement of a mature bowel habit was considered when two stools had passed without stimulation or enemas within 24 h for three consecutive days. Feeding tolerance was considered when 120 ml/kg per day of enteral intake was achieved. The impact on growth was measured by difference in weight and length z-score between 36 weeks postconceptional age and birth.
Results Mean birth weight and gestational age were 875 ± 178 g and 26.2 ± 1.4 weeks. First meconium-free stool occurred at 9 (8–12) days, median (range); mature bowel habit was achieved at 16 (12–24) days; 120 ml/kg per day of enteral intake were tolerated at 16 (12–24) days and days of parenteral nutrition were 17 (11–25). The achievement of an earlier mature bowel habit was related to earlier age when 120 ml/kg per day of enteral intake was tolerated (r = 0.334, p<0.05) and with fewer days of parenteral nutrition (r = 0.338, p<0.05). Better feeding tolerance was associated with a smaller fall in weight (r = 0.329, p<0.05) and length z-score (r = 0.278, p<0.05) between birth and 36 weeks.
Conclusion Mature bowel habit acquisition and feeding tolerance are related. Better feeding tolerance allows better growth. Further studies are needed to investigate whether mature bowel habits can be accelerated and thus feeding tolerance improved.