Safety and Efficacy of Early versus Conventional Enteral Feeding after Colostomy Closure in Children with High Anorectal Malformation

Aim: The restoration of intestinal continuity after colostomy closure is a critical step and postoperative recovery is influenced by nutritional strategies.This study aimed to evaluate the safety and efficacy of early versus conventional feeding in children undergoing sigmoid colostomy closure on postoperative recovery parameters.Materials and Methods: A prospective randomized observational study was carried out at a tertiary care hospital between January 2022 and October 2025.Fifty children (<16 years) undergoing stoma closure were randomized into two groups: Group A (early feeding within 48 hours postoperatively) and Group B (conventional feeding after return of bowel function or on postoperative day 5).Demographic data, perioperative parameters, and postoperative outcomes including time to initiation of feeding, time to full feeds, bowel function recovery, complications, and hospital stay were analyzed using SPSS v24.0.Results: Of the 50 patients (39 males, 11 females; mean age 1.1 years), 25 were allocated to each group.Feeding was initiated significantly earlier in Group A (mean 18.7 hours) compared with Group B (52.6 hours; p<0.001).Time to achieve full feeds was shorter in Group A (median 42.5 hours) versus Group B (72.5 hours; p<0.001).First bowel movement occurred earlier in Group A (mean 4.1 days) than Group B (5.9 days; p<0.01).Median hospital stay was reduced in Group A (4.5 days) compared with Group B (6 days; p<0.01).No anastomotic leaks or wound dehiscence were observed.Minor complications included transient vomiting and urinary tract infections, with no significant differences between the groups. Conclusion:Early enteral feeding after stoma closure in children with high anorectal malformation is safe, well tolerated, and associated with faster recovery and shorter hospital stays compared with conventional feeding.