Abstract
Introduction The feeding regimen employed after pyloromyotomy for pyloric stenosis continues to
be a topic of debate and has yet to be evaluated in a prospective, randomized trial.
To understand the spectrum of current feeding schedules being utilized in the various
training programs, we queried the program directors or representatives about their
feeding schedules.
Methods Through the use of multiple electronic communication resources, we surveyed 47 pediatric
training programs in the United States and Canada about their postpyloromyotomy feeding
schedules. Questions included time to first feed, how the schedule is advanced, and
criteria for stopping feeds and discharge.
Results Reponses were received from 34 of the 47 institutions. Six programs had variable
times of delay before instituting feeding whether ad libitum (ad lib) or protocol.
The average time of delay was 4.3 hours. Six programs reported both ad lib feed and
protocol feeding regiments. Twelve institutions used ad lib feeding regiments. Eight
started feeding without delay. Twenty-six programs including our institution currently
employ a protocol-based feeding regiment. Of these programs, seven begin the protocol
without delay.
Conclusions Despite retrospective evidence in support of ad lib feeds after pyloromyotomy, the
majority of teaching institutions employs protocols for the postpyloromyotomy feeding
schedule. There is clearly a role for a prospective, randomized trial to compare ad
lib to schedule feeding.
Keywords
pyloric stenosis - feeding regimen - ad libitum feeds - pyloromyotomy
