An interdisciplinary project that changed practice in feeding methods after pyloromyotomy.

Postoperative feeding methods for infants with hypertrophic pyloric stenosis (HPS) have remained unchanged for several decades. Conventional feeding methods include a prolonged NPO period immediately after pyloromyotomy, followed by a slow, incremental increase in volume and strength of feedings. Recently, some surgeons have ascribed to a more rapid or ad lib feeding advancement. Needing evidence before making changes to current practice, inpatient surgical nurses at Children's Hospital Boston collaborated with a general pediatric surgeon to conduct a 6-month retrospective study of 36 HPS patients comparing conventional regimen feeds to ad lib feeds by surgeon preference. The project resulted in a study published in the Journal of Pediatric Surgery and demonstrated for staff that the interval from the operating room to toleration of full feedings was less with the ad lib group as compared to the conventional regimen group. In addition, discharges occurred sooner without readmissions occurring in either group. The project resulted in a change in practice of feeding HPS patients postoperatively from the conventional regimen method to the ad lib method.