Growth Failure and Nutritional Deficiencies in Infants with ileostomies: A Prospective Analysis

Abstract

A BSTRACT To evaluate growth trajectories and the prevalence of macro-and micronutrient deficiencies in infants with ileostomy during the postoperative period, and to compare these outcomes with age-and sex-matched surgical controls without malabsorption. The study aimed to identify the extent of nutritional compromise in this population and highlight areas requiring targeted intervention, particularly in resource-limited settings. This prospective observational study was conducted at a tertiary neonatal surgical unit between May 2023 and December 2024. Infants (0–3 months) undergoing ileostomy were enrolled and followed for 6 months postoperatively. Anthropometry, hematologic indices, and serum levels of protein, albumin, iron, ferritin, folate, Vitamin B12, and 25-hydroxyvitamin D were compared with age- and sex-matched surgical controls without malabsorption. Fifty infants with ileostomy and 50 controls were included. At 6 months, 58.3% of ileostomy infants remained severely underweight (weight-for-age < −3 standard deviation), and also severely stunted. Hypoproteinemia (70.8%) and hypoalbuminemia (44.5%) persisted despite nutritional rehabilitation. Anemia was present in 37% of ileostomy infants, associated with low serum iron, elevated total iron-binding capacity, and high ferritin, indicating inflammation-driven functional iron deficiency. Deficiencies of folate (10.4%), Vitamin B12 (14.6%), and Vitamin D (18%) were common. Only 4% underwent stoma closure within 6 months. Infants with ileostomies experience profound and persistent growth failure and multiple micronutrient deficiencies despite nutritional support. Early recognition, proactive nutritional rehabilitation, and timely stoma closure guided by clinical stability rather than weight alone are essential to improve growth and developmental outcomes.