Minimal enteral feeding reduces the risk of sepsis in feed-intolerant very low birth weight newborns.
OBJECTIVE
To evaluate the efficacy and safety of minimal enteral feeding (MEF) nutritional practice in feed-intolerant very low birth weight (VLBW) infants.


METHODS
A retrospective design using data reported in the clinical charts of VLBW newborns consecutively observed in neonatal intensive care units (NICU) that presents feed intolerance. During the study period, two feeding strategies were adopted: total parenteral nutrition (PN) (group 1) or PN plus MEF (group 2), for at least 24 h. Primary outcome was the time to reach full enteral feeding; secondary outcomes were the occurrence of sepsis, the time to regain birth weight, the length of hospitalization, the occurrence of necrotizing enterocolitis (NEC) Bell stage >II and death.


RESULTS
In total, 102 newborns were evaluated: 51 in group 1, and 51 in group 2. Neonates in group 2 achieved full enteral nutrition earlier (8 days, interquartile range [IQR] 5) compared with subjects receiving total PN (11 days, IQR 5, p < 0.001). A reduction of sepsis episodes was observed in group 2 (15.7%) compared with group 1 (33.3%, p = 0.038). Additionally, subjects in group 2 regained their birth weight and were discharged earlier. The occurrence of NEC and death were similar in the two groups.


CONCLUSIONS
Minimal enteral feeding in very low birth weight infants presenting feed intolerance reduces the time to reach full enteral feeding and the risk of sepsis. This feeding practice does not increase the risk of necrotizing enterocolitis and death.
Terrin
Gianluca
G
Department of Paediatrics, University of Naples Federico II, Naples, Italy. terrin@libero.it
Passariello
Annalisa
A
Canani
Roberto Berni
RB
Manguso
Francesco
F
Paludetto
Roberto
R
Cascioli
Concetta
C
D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D007225:Infant Food; D007228:Infant Nutrition Disorders / Q000517:prevention & control* / Q000628:therapy; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007902:Length of Stay; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000517:prevention & control*