Managing newborn ileostomies

Abstract

The early post-ileostomy medical management of neonates is not clearly defined. A retrospective chart review of all infants who received an ileostomy March 2010- December 2011, identified the post-operative ileostomy progress of each infant. There were 16 cases of neonatal ileostomy during the study period. Over the first 14 postoperative days there was no weight gain. By 21 days the infants were gaining a median 140 g/week. The median stoma output was 5 mls/kg/dy during the first 7 days increasing to 17.5-20 mls/kg/dy. Weight gain or weight loss was closely related to the consistency and volume of the stoma output. Ten infants had a high stoma output >20mls/kg/dy (3 preterm, 7 term). This high stoma output was associated with sub-optimal weight gain. This study provides a template for the expectant management of newborn infants after an ileostomy. The critical issues are weight gain, stoma output and local and systemic complications.