What to do about weak intestinal function in premature infants

Generally, diseases that premature infants are prone to develop due to weak intestinal functions mainly include physiological abdominal distension, feeding intolerance, neonatal necrotizing enterocolitis, congenital intestinal atresia, and congenital megacolon. If intestinal-related discomfort is observed in a premature infant, prompt consultation at the neonatology department of a regular hospital is necessary. Detailed explanations are as follows:

1. Physiological Abdominal Distension

Due to weak intestinal motility in premature infants, gas produced during food digestion tends to accumulate in the intestines, causing abdominal distension, typically without other abnormal symptoms. Gently massaging the infant's abdomen can help stimulate intestinal motility. Burping the infant promptly after feeding helps release gas from the stomach. Additionally, simethicone emulsion may be used under medical guidance to help relieve intestinal gas accumulation and alleviate abdominal distension.

2. Feeding Intolerance

Premature infants often have insufficient secretion of intestinal digestive enzymes and poor adaptation to milk volume or milk composition, making them prone to vomiting, diarrhea, and slow weight gain. Adjusting the feeding method by choosing formula specifically designed for premature infants and feeding small volumes frequently can help. Additionally, under medical guidance, probiotics such as Bifidobacterium tetra-联合 viable tablets, Bacillus subtilis-bifidobacterium licheniformis viable granules, and Clostridium butyricum-bifidobacterium viable powder may be used to regulate intestinal flora and improve digestive function.

3. Neonatal Necrotizing Enterocolitis

Premature infants have poor intestinal mucosal barrier function, making them susceptible to bacterial invasion, which can cause intestinal inflammation and mucosal necrosis. Symptoms include abdominal distension, vomiting with blood, and bloody stools. Immediate fasting is necessary, along with anti-infective treatment under medical guidance using medications such as piperacillin sodium-tazobactam sodium for injection and cefotaxime sodium for injection. Parenteral nutrition support is also required. If intestinal perforation occurs, laparoscopic repair of intestinal perforation or intestinal resection may be necessary.

4. Congenital Intestinal Atresia

This condition results from abnormal embryonic development, causing a segment of the intestine to be closed off. In premature infants, intestinal contents cannot pass normally, leading to symptoms such as vomiting, abdominal distension, and absence of meconium excretion. This is a rare pathological condition. Laparoscopic anastomosis surgery should be performed as early as possible after medical evaluation to restore intestinal patency. Parenteral nutrition support is needed postoperatively, gradually transitioning to normal feeding after intestinal function recovers.

5. Congenital Megacolon

This condition is caused by the absence of intestinal ganglion cells, resulting in loss of intestinal motility and fecal accumulation that leads to colonic dilation. Premature infants typically present with refractory constipation and abdominal distension. Under medical guidance, glycerin suppositories or glycerin enema agents may be used to assist defecation and relieve abdominal distension. For severe cases, a transanal corrective surgery for megacolon may be required to remove the affected intestinal segment and restore normal intestinal motility.

In daily life, attention should be paid to feeding hygiene for premature infants to avoid milk contamination; keep the infant's abdomen warm to prevent cold exposure; closely monitor bowel movements and abdominal distension, seeking medical attention promptly if abnormalities occur; and regularly monitor weight gain to assess recovery of intestinal function.