Modern approaches to enteral nutrition in neonatal surgery: a lecture

Cover Page

Cite item

Full Text

Abstract

Nutrition of newborns is critical, because it is an adaptation period to the harsh environment. Breast milk is considered the optimal food for newborns, providing the foundation for immune system. Breastfeeding is essential for the development of a healthy gut microbiota. This is supported by a significant correlation between breastfeeding duration and the risk of infectious diseases in newborns. However, in situations like severe pathological conditions, breastfeeding becomes impossible. In such cases, breast milk substitutes are required, followed by specialized enteral nutrition formulas. A particular challenge in the early postoperative period is providing all essential nutrients when natural feeding is not feasible. Enteral nutrition is more physiological than parenteral. Therefore, breast milk is the best option for newborns, and semi-elemental formulas are used in its absence. This lecture compares breast milk and various specialized formulas. It also discusses the characteristics of artificial feeding in newborns and provides a clinical case illustrating nutritional support in the development of chylothorax.

About the authors

Julia V. Erpuleva

G.N. Speransky Children’s City Clinical Hospital No. 9; Russian Medical Academy of Continuous Professional Education

Author for correspondence.
Email: ErpulevaYuV@rmapo.ru
ORCID iD: 0000-0002-8018-3366
SPIN-code: 7319-9906

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow; Moscow

References

  1. Erpulyova YV. Modern possibilities of pediatric nutritional support. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2015;5(1):108–110. doi: 10.17816/psaic138 EDN: TRQBSN
  2. Erpuleva JV. A differentiated approach to the appointment of fat emulsions in pediatric practice. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2013;3(2):80–88. EDN: RFMAOB
  3. Erpuleva YV, Chubarova AI, Weinstein NP, et al. Complications of long-term parenteral nutrition and children of breast age. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(1):59–69. doi: 10.17816/psaic317 EDN: ZBIQWH
  4. Averyanova YV, Vessel L, Erpulyova YV, et al. Federal clinical recommendations «Treatment of children with the short bowel syndrome». Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2014;(4):92–108. doi: 10.17816/psaic88 EDN: RKUCKQ
  5. Lisitsa IA, Aleksandrovich YuS, Zavyalova AN, et al. Features of refeeding syndrome in patients of pediatric intensive care units (literature review). Messenger of Anesthesiology and Resuscitation. 2024;21(5):97–107. doi: 10.24884/2078-5658-2024-21-5-97-107 EDN: UCHKON
  6. Markova AA, Kashkina EI, Aparkina AV. The role of nutrition in the prevention and treatment of inflammatory bowel diseases. Russian Journal of Preventive Medicine. 2023;26(3):123–129. doi: 10.17116/profmed202326031123 EDN: MMNDRO
  7. Mukhina YuG, Chubarova AI, Geraskina VP. Current problems of lactase insufficiency in infants. Vopr. det. dietol. (Pediatric Nutrition). 2003;1(1):50–56. EDN: IACTFF
  8. Sofronova LN. Osteopenia of preterm infants. Russian Bulletin of Perinatology and Pediatrics. 2010;55(5):21–26. doi: 10.21508/1027-4065-2025-70-1-5-10 EDN: NOGHMR
  9. Chubarova AI. Necrotizing enterocolitis of newborns. Experimental and clinical gastroenterology. 2012;(1):70–75. EDN: RWHGRP
  10. Anastasevich LA, Belmer SV. Protein component of nutrition for children in the first year of life. Lechaschi Vrach. 2008;(1):34–36. (In Russ.) EDN: IITHYD
  11. Erpuleva J, Lekmanov A. Effectiveness of “all-in-one” nutrition in children in ICU. Clin Nutr Suppl. 2011;6(S1):121. doi: 10.1016/S1744-1161(11)70310-6
  12. He X, Tinghäll Nilsson U, Mishchuk DO, et al. Impact of formula protein quantity and source on infant metabolism: serum, urine, and fecal metabolomes of a randomized controlled study. Am J Clin Nutr. 2025;121(4):853–864. doi: 10.1016/j.ajcnut.2025.02.002 EDN: FHPORM
  13. Höck M, Höller A, Hammerl M, et al. Dietary treatment of congenital chylothorax with skimmed breast milk. Ital J Pediatr. 2021;47(1):175. doi: 10.1186/s13052-021-01125-1 EDN: BNZRLD
  14. Klein CJ. Nutrient requirements for preterm infants formulas. J Nutr. 2002;132(6S1):1395S–577S. doi: 10.1093/jn/132.6.1395S
  15. Lapillonne A, Fidler Mis N, Goulet O, et al. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Lipids. Clin Nutr. 2018;37(6PtB):2324–2336. doi: 10.1016/j.clnu.2018.06.946
  16. Purkiewicz A, Regin KJ, Mumtaz W, Pietrzak-Fiećko R. Breastfeeding: The Multifaceted Impact on Child Development and Maternal Well-Being. Nutrients. 2025;17(8):1326. doi: 10.3390/nu17081326
  17. Neumann L, Springer T, Nieschke K, et al. ChyloBEST: chylothorax in infants and nutrition with low-fat breast milk. Pediatr Cardiol. 2020;41(1):108–113. doi: 10.1007/s00246-019-02230-z EDN: VCNFHF
  18. Program for optimizing infant feeding in the Russian Federation: methodological recommendations. Moscow: Federal State Autonomous Institution “National Medical Research Center for Children’s Health” of the Ministry of Health of the Russian Federation; 2019. 112 p. Available from: https://nczd.ru/wp-content/uploads/2019/12/Met_rekom_1_god_.pdf Accessed: Des 12, 2025. (In Russ.) ISBN: 978-5-6042256-5-3 EDN: NWURZA
  19. Resch B, Yildiz GS, Reiterer F. Congenital chylothorax of the newborn: a systematic analysis of published cases between 1990 and 2018. Respiration. 2022;101(1):84–96. doi: 10.1159/000518217 EDN: SHKVDU
  20. Rocha G, Arnet V, Soares P, et al. Chylothorax in the neonate - A stepwise approach algorithm. Pediatr Pulmonol. 2021;56(10):3093–3105. doi: 10.1002/ppul.25601 EDN: WMVQZJ
  21. Ruangnapa K, Anuntaseree W, Saelim K, et al. Treatment and outcomes of chylothorax in children: 20-year experience of a single institute. J Thorac Dis. 2022;14(10):3719–3726. doi: 10.21037/jtd-22-474 EDN: MOKEMC
  22. Samanidis G, Kourelis G, Bounta S, Kanakis M. Postoperative chylothorax in neonates and infants after congenital heart disease surgery-current aspects in diagnosis and treatment. Nutrients. 2022;14(9):1803. doi: 10.3390/nu14091803 EDN: JSFBCF
  23. Skidan IN, Pyrieva EA. Breast milk proteins as a focus for the improvement of recipes for infant adapted milk formulae. Voprosy pitaniia [Problems of Nutrition]. 2017;86(4):37–49. EDN: ZFTKHX
  24. Sleem B, Abdul Khalek J, Makarem A, et al. Chylothorax: a rare postoperative complication in paediatric cardiac surgery patients - a 15-year retrospective study from a tertiary care centre in a developing country. Cardiol Young. 2025;35(4):798–804. doi: 10.1017/S104795112500126X EDN: VRJABH
  25. Vandenplas Y, Plaskie K, Hauser B. Safety and adequacy of a semi-elemental formula for children with gastro-intestinal disease. Amino Acids. 2010;38(3):909–914. doi: 10.1007/s00726-009-0298-8
  26. Zhang RG, Liu YM, Yao ZY, et al. Risk factors of chylothorax after congenital heart surgery in infants: a single-centre retrospective study. Ther Clin Risk Manag. 2024;20:161–168. doi: 10.2147/TCRM.S436991 EDN: TSLKHV

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2025 Eco-Vector

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Согласие на обработку персональных данных

 

Используя сайт https://journals.rcsi.science, я (далее – «Пользователь» или «Субъект персональных данных») даю согласие на обработку персональных данных на этом сайте (текст Согласия) и на обработку персональных данных с помощью сервиса «Яндекс.Метрика» (текст Согласия).