Editing Preterm birth (section)

==== Gastric residuals ====
For preterm infants in neonatal intensive care on [[Gavage|gavage feeds]], monitoring the volume and colour of gastric residuals, the milk and gastrointestinal secretions that remain in the stomach after a set amount of time, is common standard of care practice.<ref name="Abiramalatha_2023">{{cite journal |last1=Abiramalatha |first1=T |last2=Thanigainathan |first2=S |last3=Ramaswamy |first3=VV |last4=Rajaiah |first4=B |last5=Ramakrishnan |first5=S |title=Re-feeding versus discarding gastric residuals to improve growth in preterm infants. |journal=The Cochrane Database of Systematic Reviews |date=30 June 2023 |volume=2023 |issue=6 |pages=CD012940 |doi=10.1002/14651858.CD012940.pub3 |pmid=37387544 |pmc=10312053 |ref=Abiramalatha_2023 }}</ref> Gastric residual often contains gastric acid, hormones, enzymes, and other substances that may help improve digestion and mobility of the gastrointestinal tract.<ref name="Abiramalatha_2023" /> Analysis of gastric residuals may help guide timing of feeds.<ref name="Abiramalatha_2023" /> Increased gastric residual may indicate feeding intolerance or it may be an early sign of necrotizing enterocolitis.<ref name="Abiramalatha_2023" /> Increased gastric residual may be caused by an underdeveloped gastrointestinal system that leads to slower gastric emptying or movement of the milk in the intestinal tract, reduced hormone or enzyme secretions from the gastrointestinal tract, duodenogastric [[Gastroesophageal reflux disease|reflux]], formula, medications, and/or illness.<ref name="Abiramalatha_2023" /> The clinical decision to discard the gastric residuals (versus re-feeding) is often individualized based on the quantity and quality of the residual.<ref name="Abiramalatha_2023" /> Some experts also suggest replacing the fresh milk or curded milk and bile-stained aspirates, but not replacing haemorrhagic residual.<ref name="Abiramalatha_2023" /> Evidence to support or refute the practice of re-feeding preterm infants with gastric residuals is lacking.<ref name="Abiramalatha_2023" />