Fresh grass, cocoa powder or the use of domperidone (1.1mg/kg po SID) may
increase dam lactation.
If fresh mare’s milk is not available then the next best thing is frozen mares
milk, followed by goat’s milk, followed by commercial replacers. If commercial
replacers are used, ensure consistency in mixing up. It may be prudent to
start at 50% strength when initiating enteral feeding. Ensure excellent
hygiene; boil water, sterilise equipment (baby ‘Milton’ is excellent for this), and
store premade milk in the fridge for up to 48 hours only.
The method of administration depends on many clinical factors including
mental status and gastrointestinal function. Options include bottle feeding,
bowl feeding, stomach tubing and indwelling feeding tubes. Beware the
dummy foal that has an overzealous but un- coordinated suck reflex. These
foals are at a high risk of aspiration pneumonia if bottle fed by inexperienced
hands. Indwelling feeding tubes are tolerated well and can easily be placed
under diazepam sedation with the use of endoscopy or radiography to ensure
correct positioning. These are then sutured in place to the nostrils and
forehead with tape around the muzzle to help secure. Bowl feeding is much
safer than bottle feeding but it can be frustrating and time consuming at first
with the dummy foals, especially the colt foals.
The most common problem with providing enteral nutrition is over feeding.
Aim to initially provide 5% body weight over the first twenty four hours, divided
into 12 2 hourly feeds (200ml q. 2 hrs) then increase up to 10% of body weight
throughout the second day, then increase this to 25% body weight/24hrs over
the next couple of days. The normal healthy TB foal should gain approx. 1-2kg
per day. Ideally the neonatal foal should not go for longer than 3 hours
without feeding.
Glutamine, a non essential amino acid in the healthy foal, becomes important
in disease states. Enterocytes can extract glutamine directly from the GI tract
and require it for healthy enterocyte regeneration. There is a large body of
evidence demonstrating improved long term outcomes when humans in
critical care are supplemented with glutamine. Glutamine is relatively cheap
and easily available from health stores. The author recommends 10-20g over
24 hours, added to enteral feeds.
•
•
•
•
•
0-1 week of age feed every 2-3 hours
1-2 week of age feed every 3-6 hours. SICK foals need more frequent
feeding
2-4 weeks of age feed 3-6 feedings per day. Begin offering creep feed
and small quantities hay
4-6 weeks 2-3 feedings per day. Increase solid food intake
>6 weeks stop feeding milk/ milk substitute if solid intake adequate
There is conflicting evidence for the use of gastric acid modifiers in the
neonate.
If enteral feeding cannot be tolerated, parenteral nutrition should be
considered. This will require infusion pumps or controlled IV giving sets,
15-‐18
February
2016
East
London
Convention
Centre,
East
London,
South
Africa
204