Early feeding advancement in very low-birth-weight infants with intrauterine growth retardation and increased umbilical artery resistance.
BACKGROUND
To investigate whether intrauterine growth retardation (birth weight <10th percentile), increased umbilical artery resistance (resistance index >90th percentile measured by Doppler velocimetry), or brain sparing (increased umbilical artery resistance and decreased middle cerebral artery resistance index <5th percentile) were associated with early feeding intolerance in very low-birth-weight (VLBW, <1,500 g) infants.


METHODS
From July 1999 to December 2000, 124 inborn VLBW infants were enrolled in a prospective trial evaluating early enteral nutrition after a standardized feeding protocol (daily feeding advancement, 16 mL/kg birth weight). Feeding tolerance was assessed as the age at which full enteral feeds (150 mL/kg daily) were achieved. Data are shown as median, 25th, and 75th percentiles.


RESULTS
Full enteral feeds were achieved at 15 days (range, 12-21 days) of age for all infants. Intrauterine growth retardation (full enteral feeding achieved at 14 days; range, 12-21 days), increased umbilical artery resistance (full enteral feeding achieved at 14 days; range, 11-16 days), and brain sparing (full enteral feeding achieved at 15 days; range, 14-20 days) were not associated with early feeding intolerance.


CONCLUSIONS
Very low-birth-weight infants with intrauterine growth retardation, increased umbilical artery resistance, and brain sparing tolerated enteral feeding as well as appropriate-for-gestational-age VLBW infants.
Departments of Pediatrics, Ulm University, Ulm, Germany. walter.mihatsch@medizin.uni-ulm.de
Walter Alexander
WA
Mihatsch
Frank
F
Pohlandt
Axel Rainer
AR
Franz
Felix
F
Flock
D002536:Cerebral Arteries / Q000502:physiology; D004750:Enteral Nutrition / Q000009:adverse effects; D005260:Female; D005317:Fetal Growth Retardation / Q000503:physiopathology; D006801:Humans; D007225:Infant Food; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000502:physiology*; D017078:Laser-Doppler Flowmetry / Q000379:methods; D008297:Male; D011446:Prospective Studies; D013997:Time Factors; D014469:Umbilical Arteries / Q000502:physiology*; D014655:Vascular Resistance