ABSTRACT
The baby is returned to an incubator (or radiant heat cot) at the thermoneutral temperature for its size and maturity. An i.v. infusion of dextrose/saline is continued in the postoperative period and further fluid and electrolyte management depends on clinical progress, loss by gastro-duodenal aspiration and serum electrolyte levels. Postoperatively, patients have a prolonged period of bile-stained aspirate through the nasogastric tube, which is mainly due to the inability of the markedly dilated duodenum to produce effective peristalsis, and to a lesser extent, partial mechanical obstruction by the feeding tube. Enteral feeding through the transanastomotic jejunal tube is generally started within 24-48 hours postoperatively. The tip of the transanastomotic tube should be checked by X-ray prior to starting feeds. The commencement of oral feeding depends on the decrease of the gastric aspirate, and may be delayed for several days and occasionally for 2 weeks or longer. Once the volume of the gastric aspirate decreases, the nasojejunal tube is withdrawn and the infant can be started on oral feeding.
