ABSTRACT
You are consulted on a 6-week-old baby boy in the neonatal intensive care unit (NICU) with symptoms of feeding intolerance and high gastric residuals. The baby was born by emergent Cesarean section at 25 2/7 weeks of gestation to a 30-year-old, G4 P1A3 woman after prolonged premature rupture of membranes. Perinatal steroids were administered to the mother. The baby weighed 900 g at birth, and Apgar scores were 8 and 9 at 1 and 5 minutes, respectively. After birth, the baby required non-invasive respiratory support. He was intubated for respiratory failure at 2 days of life but extubated within a few days. He has since been managed with caffeine for daily apnea and bradycardia episodes. A patent ductus arteriosus closed after fluid restriction only. Continuous gavage feedings with breast milk were started at 1 week of age and slowly advanced to goal by 3 weeks of age. He is just completing an antibiotic course for a Serratia urinary tract infection.
