Continuous enteral feeding impairs gallbladder emptying in infants

Objective: The objective was to test the hypothesis that continuous enteral feeding impairs gallbladder emptying in infants. Study design: A prospective crossover study was performed in 15 infants: (1) bolus enteral feeds were given in phase A, (2) a continuous milk feed was given for 3 days in phase B, and (3) bolus feeds were resumed in phase C. The gallbladder was studied with ultrasonography in phase A, on days 1 and 3 of phase B, and at the start and on days 2 and 4 of phase C. Results: Baseline volume was 116.1 mm3 (range, 48.1 to 374.8 mm3) in phase A and 293.3 mm3 (range, 109.4 to 1134.9 mm3) (P < .001) after 3 days of phase B; it returned to the phase A value after 4 days of phase C. The contraction index was 65.2% (range, 40.6% to 78.2%) in phase A and 1.7% (range, 0% to 8.4%) (P < .001) after 3 days of phase B. It returned to its phase A value immediately after bolus enteral feeds were resumed in phase C. Conclusions: Continuous enteral feeding leads to an enlarged, noncontractile gallbladder in infants. Emptying is observed immediately after bolus feeds are resumed, and volume returns to baseline after 4 days. The mode of feeding has important bearings on the motility of the extrahepatic biliary tree. (J Pediatr 2001;138:822-5)