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Growth trajectories and need for oral feeding support among infants with neonatal encephalopathy treated with therapeutic hypothermia

Journal of Perinatology (2024)Cite this article

Subjects

Abstract

Objective

Identify feeding supports required among infants with neonatal encephalopathy and determine growth trajectories to 3 years.

Study design

Single-center retrospective cohort study of 120 infants undergoing therapeutic hypothermia. Logistic regression and stratified analyses identified whether clinical factors, EEG-determined encephalopathy severity, and MRI-based brain injury predict feeding supports (nasogastric tube, oral feeding compensations) and growth.

Results

50.8% of infants required feeding supports in the hospital, decreasing to 14% at discharge. Moderate-to-severe encephalopathy and basal ganglia injury predicted feeding support needs. Yet, 35% of mildly encephalopathic infants required gavage tubes. Growth trajectories approximated expected growth of healthy infants.

Conclusion

Infants with neonatal encephalopathy—even if mild—frequently experience feeding difficulties during initial hospitalization. With support, most achieve full oral feeds by discharge and adequate early childhood growth. Clinical factors may help identify infants requiring feeding support, but do not detect all at-risk infants, supporting routine screening of this high-risk population.

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Fig. 1: Growth trajectories from birth to <5 months, stratified by whether infant required NG feeds in the NICU.
Fig. 2: Growth trajectories from birth to <5 months, stratified by severity of encephalopathy determined by electroencephalogram (EEG).

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Data availability

The datasets analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

Jennifer Prial received funding from the Brigham and Women’s Hospital Division of Newborn Medicine Undergraduate Summer Student Research program.

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Authors and Affiliations

  1. Division of Newborn Medicine, Department of Pediatrics, Brigham and Women’s Hospital, Boston, MA, USA

    Jennifer Prial, Hoda El-Shibiny, Mohamed El-Dib, Jennifer Benjamin, Carmina Erdei, Pamela Dodrill, Eniko Szakmar & Katherine A. Bell

  2. Harvard Medical School, Boston, MA, USA

    Mohamed El-Dib, Jennifer Benjamin, Carmina Erdei, Pamela Dodrill & Katherine A. Bell

  3. Division of Neonatology, Pediatric Center, Semmelweis University, Budapest, Hungary

    Eniko Szakmar

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  1. Jennifer Prial
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Contributions

KAB conceptualized and designed the study; JP, HE-S, ME, ES, CE, JB, and KAB contributed to data acquisition; JP, HE-S, and KAB analyzed the data; JP and KAB drafted the original manuscript; and all authors interpreted the results, provided critical review of the manuscript draft and approved the final version.

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Correspondence to Katherine A. Bell.

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Prial, J., El-Shibiny, H., El-Dib, M. et al. Growth trajectories and need for oral feeding support among infants with neonatal encephalopathy treated with therapeutic hypothermia. J Perinatol (2024). https://doi.org/10.1038/s41372-024-01983-7

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