Nutritional care process in a premature female patient with a high-output ileostomy: challenges in stoma care - case report
DOI:
https://doi.org/10.29105/respyn24.4-880Keywords:
premature, gastroschisis, intestinal atresia, pediatric malnutrition, Nutrition Care ProcessAbstract
Introduction: Premature newborns (PN) have a higher prevalence of congenital conditions, such as gastroschisis and intestinal atresia, which compromise oral feeding, alter intestinal structure and function, and promote a pro-inflammatory state. This leads to pediatric malnutrition, growth and developmental delays, and increased morbidity and mortality. Objective: To describe the nutritional care process and clinical challenges in a premature infant with a high-output ileostomy that was difficult to manage. Methods: We present a clinical case involving the nutritional care process (NCP) of a 6-month, 15-day-old PN with a previous diagnosis of gastroschisis and intestinal atresia, who underwent gastroschisis closure and ileocecal anastomosis, later developing a high-output ileostomy. The patient required prolonged parenteral nutrition due to poor enteral tolerance, resulting in severe malnutrition. A nutritional assessment was conducted, including dietary history, anthropometric measurements, biochemical profiles, medical tests, nutrition-related clinical findings, and monitoring. Nutritional diagnoses were identified, leading to a tailored intervention involving concentrated infant formula and rice cereal modulation for an astringent effect and increased caloric density. Results: Improved enteral tolerance and growth indicators were observed. Conclusion: Modulating feedings with rice cereal and formula concentration may be an effective strategy to enhance enteral tolerance, improve nutritional status, and support catch-up growth.
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Copyright (c) 2025 Adbel Zaid Martínez Báez, Daniel Patiño Contreras , Grecia Meriva González Cavazos, Sofia Cuellar Robles , María de la Luz Pérez Ávila, Edna Judith Nava González
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