Safety of initiating early enteral feeding with slow volume advancement in preterm infants.
OBJECTIVE
To determine the safety of enteral feeding within 24 hours of life with slow volume increase on the incidence of necrotizing enterocolitis (NEC) and late-onset sepsis (LOS).


METHODS
Prospective descriptive study.


METHODS
Between January 1998 and December 2001, 117 preterm infants with birth weight < or =1750 g were recruited prospectively, 102 in the human-milk-fed group (HMG) and 15 in the formula-fed group (FG). Feeds were advanced by increments of 10 mL/kg/d, aimed at 150 mL/kg/d in 15 days. Charts of 146 preterm infants admitted during 1996-1997 were reviewed for pre-study incidences of NEC and LOS.


RESULTS
NEC developed 3.92% in HMG and 20% in FG (p =.044). LOS developed 2.94% in HMG and 13.33% in FG (p = 0.122). The overall incidence of NEC was almost similar (5.98% vs. 6.16%) while that of LOS was lower (4.27% vs. 12.32%) when compared to the pre-study incidences.


CONCLUSIONS
The present study provides a practice that seems to reduce LOS risk without increasing NEC risk and confirms the protective effect of human milk against NEC.
Jirapaet
Kriangsak
K
Department of Pediatrics, Faculty ofMedicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. sikjr@mahidol.ac.th
Jirapaet
Veena
V
Sritipsukho
Suthida
S
D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods*; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D005247:Feeding Behavior / Q000502:physiology*; D005260:Female; D006801:Humans; D015994:Incidence; D041943:Infant Formula; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D008297:Male; D008895:Milk, Human; D011446:Prospective Studies; D012306:Risk; D012449:Safety; D018805:Sepsis / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control; D013785:Thailand / Q000453:epidemiology; D013997:Time Factors