Gastrointestinal Structure and Function

Sandra Sundquist Beauman, MSN, RNC-NIC / January 2018


Nutrition is one of the most basic needs of an infant.

Many infants admitted to the NICU come for respiratory illness and other conditions, but all must be able to tolerate enteral nutrition before discharge. Most are required to take feedings via breast or bottle prior to discharge. The development of the gastrointestinal tract is integral to achieving this outcome.

Early feeding

We have learned that feeding premature infants early in life leads to better outcomes, as a dormant gastrointestinal tract is prone to developing necrotizing enterocolitis (NEC) once feedings are introduced.

In fact, the fetus swallows as much as 450 mL of amniotic fluid a day in utero (at term) that provides important nutrients to the intestine thereby aiding growth and development. This is not available after early delivery, yet this development continues and requires nutrition.

The closest thing we can provide the infant to amniotic fluid is human milk. Therefore, early feedings with colostrum, high in many nutrients found in amniotic fluid and important immune factors to prevent infection, is the best.

Gastrointestinal anomalies

In addition, as the gastrointestinal tract develops, there are certain critical time points when anomalies like atresias and strictures, omphalocele, gastroschisis, trachea-esophageal fistula, and others may develop. The presence of these anomalies impacts care after delivery and the progression of enteral nutrition.

Most can be easily corrected with surgery, but in some cases, occur more often with other anomalies.  Careful evaluation is needed to identify the presence and impact of other anomalies and support the infant through the correction of the gastrointestinal tract anomaly.

Learn more and earn credits

Learn more about this topic in our recorded webinar, Gastrointestinal Development: Preparation for Enteral Feeds, where we discuss the fetal development of the gastrointestinal tract in both structure and function, the above-mentioned structural anomalies, and usual care. This program offers 1.0 Nursing contact hours or 1.0 CPE Dietician credits.

BONUS: Use promo code EA2ARH to access the recorded webinar at no charge. This code will be offered through March 31, 2018.


Looking for more information on this subject?
Read How Human Milk Can Reduce the Devastating Impact of NEC.


About the Author

Sandy Sundquist Beauman has over 30 years of experience in neonatal nursing. In addition to her clinical work, she is very active in the National Association of Neonatal Nurses, has authored or edited several journal articles and book chapters, and speaks nationally on a variety of neonatal topics. She currently works in a research capacity to improve healthcare for neonates. Sandy is also a clinical consultant with Medela LLC. You can find more information about Sandy and her work and interests on LinkedIn.