Feeding Intolerance in a 5-day-old Infant

Abstract

A 5-day-old male infant receiving gavage feedings of expressed human milk every 3 hours develops feeding intolerance after four feedings. The volume was started at 5 mL per feeding and advanced slowly to a maximum of 12 mL (60 mL/kg per day). ### Prenatal History ### Birth History ### Subsequent Course The baby was intubated and remained NPO for the first few postnatal days as a precautionary measure due to perinatal depression attributed to prolonged maternal magnesium sulfate administration and difficult delivery of the head. The baby did not manifest signs and symptoms of hypoxic-ischemic encephalopathy or major end-organ injuries. By postnatal day 3, he was extubated and began to receive oxygen via high-flow nasal cannula. The baby received caffeine to help wean him off the ventilator and prevent extubation failure. He was kept NPO, and cimetidine was administered because of upper gastrointestinal bleeding believed to be …