Enemas, suppositories and rectal stimulation are not effective in accelerating enteral feeding or meconium evacuation in low-birthweight infants: a systematic review

Acta Paediatr. 2016 Nov;105(11):1280-1287. doi: 10.1111/apa.13540. Epub 2016 Sep 8.

Abstract

Early full enteral feeding in preterm infants decreases morbidity and mortality. Our systematic review covered the effectiveness of rectal stimulation, suppositories and enemas on stooling patterns and feeding tolerance in low-birthweight infants born at up to 32 weeks. It comprised seven studies published between 2007 and 2014 and covered 495 infants.

Conclusion: Suppositories were ineffective in shortening the time to reach full enteral feeding, and the evidence on enemas was contradictory. Enemas and rectal stimulation did not shorten the time until complete meconium evacuation was reached. Further research into safe, effective interventions to accelerate meconium excretion is needed.

Keywords: Enemas; Feeding tolerance; Low-birthweight infants; Meconium excretion; Suppositories.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Defecation / physiology*
  • Enema / methods*
  • Enteral Nutrition / methods*
  • Humans
  • Infant, Extremely Premature*
  • Infant, Newborn
  • Infant, Very Low Birth Weight*
  • Intensive Care Units, Neonatal
  • Meconium / metabolism*
  • Physical Stimulation / methods*
  • Suppositories / therapeutic use*
  • Time Factors

Substances

  • Suppositories