Slow versus rapid enteral feeding advancement in preterm newborn infants 1000-1499 g: a randomized controlled trial.
OBJECTIVE
To evaluate whether preterm neonates weighing 1000-1499 g at birth receiving rapid enteral feeding advancement at 30 mL/kg/day attain full feedings (180 mL/kg/day) earlier than those receiving slow enteral feeding advancement at 20 mL/kg/day without increase in the incidence of feeding intolerance or necrotizing enterocolitis.


METHODS
A total of 100 stable intramural neonates weighing between 1000 and 1499 g and gestational age less than 34 weeks were randomly allocated to enteral feeding (expressed human milk or formula) advancement of 20 mL/kg/day (n = 50) or 30 mL/kg/day (n = 50).


RESULTS
Neonates in the rapid feeding advancement group achieved full volume feedings before the slow advancement group (median 7 days vs. 9 days) (p < 0.001), had significantly fewer days of intravenous fluids (median 2 days vs. 3.4 days) (p < 0.001), shorter length of stay in hospital (median 9.5 days vs. 11 days) (p = 0.003) and regained birth weight earlier (median 16 days vs. 22 days) (p < 0.001). There were no statistical differences in the proportion of infants with apnea, feed interruption or feed intolerance.


CONCLUSIONS
Rapid enteral feeding advancements of 30 mL/kg/day are well tolerated by stable preterm neonates weighing 1000-1499 g.
Krishnamurthy
Sriram
S
Department of Pediatrics, University College of Medical Sciences and Guru Tegh Bahadur Hospital, Delhi, India. drsriramk@yahoo.com
Gupta
Piyush
P
Debnath
Sanjib
S
Gomber
Sunil
S
D016009:Chi-Square Distribution; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods*; D020345:Enterocolitis, Necrotizing / Q000209:etiology; D005260:Female; D006801:Humans; D041943:Infant Formula / Q000706:statistics & numerical data; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D019102:Infant, Very Low Birth Weight / Q000502:physiology*; D007902:Length of Stay; D008297:Male; D008895:Milk, Human; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome