International Journal of Contemporary Pediatrics | May-June 2018 | Vol 5 | Issue 3 Page 1027 International Journal of Contemporary Pediatrics Singh SK et al. Int J Contemp Pediatr. 2018 May;5(3):1027-1030 http://www.ijpediatrics.com pISSN 2349-3283 | eISSN 2349-3291 Original Research Article Pre-operative nutritional status affects enteral feeding in post-operative period among pediatric laparotomy cases Santosh Kumar Singh 1 , Nitika Agrawal 2 *, Kunal Das 2 , Aisha Naaz 1 INTRODUCTION Nutrition has significant impact on health and well-being. Many ailments of pediatric age group are directly related to poor nutrition and impairment of nutrition prolongs ailments of almost all type. 1 A recovery is delayed in poorly nourished child. Effect of nutrition on disease and recovery has been studied but factors causing difficulties in peri-illness nutrition is not addressed fully. Surgical procedure involving abdominal cavity of children is often having a period of fasting and slow introduction of feed. Guideline advocates starting enteral feed as early as within 24 hours for non-critically ill abdominal surgery cases. Even for surgical procedures involving gut manipulation has been advised for the same. However, adherence to this in practice is lacking. 2 While from healing of wound to regaining pre-surgical state of wellness has been linked to pre-surgical nutrition status, effects of nutrition on post-operative feed tolerance has not been answered. Moreover, data about pediatric cases are limited and extrapolation of adult population data lacks scientific backup. Himalayan Hospital is a tertiary care referral center and caters cases from all types of economic strata. Despite awareness and eagerness to implement early enteral feeding in post-operative period, unavoidable delay has been observed. This study was planned to note the trend of nutritional practices among pediatric abdominal surgery cases during immediate post- 1 Department of Surgery, 2 Department of Pediatrics, Himalayan Hospital, Swami Rama Himalayan University, Dehradun, Uttarakhand, India Received: 16 February 2018 Accepted: 17 March 2018 *Correspondence: Dr. Nitika Agrawal, E-mail: drkunaloncology@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: Early introduction of enteral feed in postoperative settings, although advocated, is not practiced universally. This study reviews post-operative feeding practices amongst pediatric surgery cases and variables affecting it. Methods: A retrospective analysis was done for children operated for abdominal conditions during 2013-2015. Data were analyzed for pre-operative variables, operative indications and procedure, post-operative events and feeding practices. Results: Seventy children underwent laparotomy during study period. Median time of starting enteral nutrition was 3rd post-operative day and full feed attainment was day 6. Severely thin/malnourished children could be started on enteral feed on 3.89+1.76 days while normal nourished children were started on 2.2+0.87 days (p<0.05). Eleven cases noted interruption of feed, regurgitation was the commonest cause. Cases of abdominal Koch’s and cases requiring gut incision showed delay in feed onset. Conclusions: Post-operative onset of enteral feed and tolerance depends on pre-surgery nourishment status, baseline disease condition and type of surgery. Keywords: Abdominal surgery, Feeding, Malnourished, Post-operative nutrition DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20181535