title: Randomized controlled trial: impact of glycerin suppositories on time to full feeds in preterm infants.
abstract: BACKGROUND
  Feed intolerance delays achievement of enteral feeding in preterm infants. Parenteral nutrition is associated with cholestasis and increased risk of sepsis. Glycerin suppositories have been used to promote gastrointestinal motility and feed tolerance.
  
  
  OBJECTIVE
  To investigate whether daily glycerin suppositories (a) reduce the time to full enteral feeding in infants born at <32 weeks' gestation, and (b) influence feed tolerance, incidence of sepsis or necrotizing enterocolitis, duration of oxygen requirement, growth or age at discharge.
  
  
  METHODS
  Design - prospective open randomized controlled trial; study population - preterm infants stratified into 2 subgroups, 24-27(+6) weeks (24-27 weeks + 6 days) and 28-31(+6) weeks; intervention - daily glycerin suppository for 10 days from 24 h of age, 250 mg (24-27(+6) weeks subgroup) or 500 mg (two 250-mg suppositories; 28-31(+6) weeks subgroup); controls - no intervention. The same feeding protocol and departmental guidelines for other aspects of neonatal intensive care were used in all subjects. Analysis was by intention to treat.
  
  
  RESULTS
  54 babies were recruited (31 males), 29 randomized to receive suppositories; 48 achieved full enteral feeds. The median (range) time to full feeds was 1.6 days shorter in intervention group babies than controls, but not statistically significant: 7.4 (4.6-30.9) days versus 9.0 (4.4-13.3) days (p = 0.780; 95% confidence interval: -1.917, 2.166). No significant differences were observed in secondary outcomes. Intervention group babies passed their first stool earlier than controls (median: day 2 vs. day 4; p = 0.016).
  
  
  CONCLUSIONS
  Regular glycerin suppositories did not reduce the time to full enteral feeds in infants born at <32 weeks' gestation in our setting.
authors: Neonatal Unit, Wishaw General Hospital, Wishaw, UK. s.khadr@ich.ucl.ac.uk
authors: Sophie N
authors: SN
authors: Khadr
authors: Samuel E
authors: SE
authors: Ibhanesebhor
authors: Connie
authors: C
authors: Rennix
authors: Hazel E
authors: HE
authors: Fisher
authors: Chikkanayakanahalli M
authors: CM
authors: Manjunatha
authors: David
authors: D
authors: Young
authors: Rosemary C
authors: RC
authors: Abara
mesh_terms: D004305:Dose-Response Relationship, Drug; D004750:Enteral Nutrition; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology; D005247:Feeding Behavior / Q000187:drug effects* / Q000502:physiology*; D005260:Female; D005769:Gastrointestinal Motility / Q000187:drug effects / Q000502:physiology; D005990:Glycerol / Q000008:administration & dosage* / Q000494:pharmacology*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D008297:Male; D008470:Meconium / Q000378:metabolism; D018805:Sepsis / Q000453:epidemiology; D013488:Suppositories; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D013488:Suppositories; D005990:Glycerol