Gastric vs Transpyloric Feeding for Bronchopulmonary Dysplasia

This trial tests two feeding methods to determine which is best for infants with severe bronchopulmonary dysplasia (BPD), a lung condition, who also struggle with feeding. Infants will try both gastric feeding (feeding into the stomach) and transpyloric feeding (feeding past the stomach into the small intestine) for a few weeks each. The trial aims to assess how each method affects the infants' breathing. Babies born before 32 weeks and showing feeding issues like reflux or chronic aspiration may be suitable candidates. As an unphased trial, this study provides a unique opportunity to enhance understanding and improve feeding methods for vulnerable infants.

The trial protocol does not specify whether you need to stop taking your current medications.

A previous study showed that feeding infants with bronchopulmonary dysplasia (BPD) through the stomach is a promising treatment option. Many infants tolerated it well, and fewer required more invasive feeding methods. However, more studies are needed to confirm its overall safety for infants with BPD.

Conversely, research has shown that feeding through a tube placed into the small intestine, known as transpyloric feeding, has been linked to negative outcomes in the hospital for infants with severe BPD. These findings raise concerns about its safety for these infants.

Unlike traditional feeding methods for bronchopulmonary dysplasia, which typically involve gastric feeding, transpyloric feeding offers a unique approach by delivering nutrition directly to the small intestine. This method can potentially reduce the risk of aspiration and improve nutrient absorption, which is crucial for infants with this condition. Researchers are excited about comparing these two feeding methods because they aim to determine which method provides better respiratory outcomes and overall growth in these vulnerable patients.

This trial will compare gastric feeding with transpyloric feeding for infants with severe bronchopulmonary dysplasia (BPD). Studies have shown that feeding infants directly into the stomach can sometimes cause lower oxygen levels in the blood, known as hypoxemia. Despite this, it is often used when infants require tube feeding into the stomach. Alternatively, transpyloric feeding, which involves feeding through a tube that bypasses the stomach and enters the small intestine, has been associated with fewer breathing issues and less frequent pauses in breathing and slow heart rate. Some research suggests that starting transpyloric feeding early may reduce the risk of death or BPD and decrease the need for breathing machines. Each feeding method has its advantages, and this trial aims to determine the best approach based on the infant's specific needs.¹⁶⁷⁸⁹