Impact of Delivery Room Gastric Lavage on Exclusive Breastfeeding Rates Among Neonates Born Through Meconium-Stained Amniotic Fluid: A Randomized Controlled Trial

• DOI: 10.1007/s13312-023-2984-8
• Publication Date: 2023-11-14T07:02:05Z
• Authors: Rahul Kumar Chaud...; Suman Chaurasia; Poonam Singh; Mayank Priyadarshi; Nowneet Kumar Bhat; Jaya Chaturvedi; Sriparna Basu
• Keywords: Gastric lavage; Meconium aspiration syndrome

Delivery-room gastric lavage reduces feeding intolerance and respiratory distress in neonates born through meconium-stained amniotic fluid (MSAF).To evaluate the effects of gastric lavage on exclusive breastfeeding and skin-to-skin contact in neonates delivered through MSAF.Randomized controlled trial.110 late preterm and term neonates delivered through MSAF not requiring resuscitation beyond initial steps.Participants randomized into gastric lavage (GL) (n=55) and no-GL (n=55) groups. The primary outcome was the rate of exclusive breastfeeding at 72±12 hours of life. Secondary outcomes were time to initiate breastfeeding and establish exclusive breastfeeding, rate of exclusive breastfeeding at discharge, time to initiate skin-to-skin contact and its duration, rates of respiratory distress, feeding intolerance, and the procedure-related complications of gastric lavage monitored by pulse oximetry and videography.Both the groups were similar in baseline characteristics. 49 (89.1%) neonates in GL group could achieve exclusive breast-feeding at 72 hours compared to 48 (87.3%) in no-GL group [RR (95% CI) 1.02 (0.89-1.17); P=0.768]. Initiation of skin-to-skin contact was significantly delayed and the total duration was significantly less in GL group compared to no-GL group. No difference in respi-ratory distress and feeding intolerance was observed. Procedure-related complications included retching, vomiting, and mild desaturation.Gastric lavage did not help to establish exclusive breastfeeding, delayed the initiation of skin-to-skin contact in delivery room and reduced its total duration. Moreover, the procedure of gastric lavage was associated with neonatal discomfort.