Continuous feeding promotes gastrointestinal tolerance and growth in very low birth weight infants.
OBJECTIVE
To compare the effects of continuous versus intermittent feeding on gastrointestinal tolerance and growth in very low birth weight (VLBW) infants.


METHODS
In a randomized, controlled trial conducted at 3 neonatal units, 70 premature infants with a gestational age 24 to 29 weeks and birth weight < 1200 g were assigned to 1 of 3 feeding methods: continuous nasogastric feeding, intermittent nasogastric feeding, or intermittent orogastric feeding. Feeding was initiated within 30 hours of birth. Daily enteral and parenteral volumes, caloric and protein intakes, growth, enteral intolerance, and clinical complications were recorded. Cox regression analysis was used to determine primary outcome, the time to achieve full enteral feeding.


RESULTS
The continuously fed infants achieved full enteral feeding significantly faster than the intermittently fed infants (hazard ratio [HR] = 1.86; 95% confidence interval [CI] = 1.07 to 3.22). In stratified analysis according to birth weight, the improvement was even more pronounced in the smallest infants, those with birth weight < or = 850 g (adjusted HR = 4.13; 95% CI = 1.48 to 11.53). Growth rate was significantly faster in the continuously fed infants ( P = .002).


CONCLUSIONS
In VLBW infants, continuous feeding seems to be better than intermittent feeding with regard to gastrointestinal tolerance and growth.
Dsilna
Ann
A
Division of Reproductive and Perinatal Health Care and Neonatal Research Unit, Department of Women and Child Health, Karolinska Institute, Stockholm, Sweden. Dsilna@kbh.ki.se
Christensson
Kyllike
K
Alfredsson
Lars
L
Lagercrantz
Hugo
H
Blennow
Mats
M
D000704:Analysis of Variance; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development; D019102:Infant, Very Low Birth Weight / Q000254:growth & development; D008297:Male; D016016:Proportional Hazards Models; D014839:Vomiting / Q000517:prevention & control