title: Very early feeding in stable small for gestational age preterm infants: a randomized clinical trial.
abstract: OBJECTIVE
  To examine the effect of initiating very early feeding on time-to-reach full feeding in stable, small for gestational age (SGA) preterm infants.
  
  
  METHODS
  Preterm infants with gestational age below 37 weeks and birth weight below the 10(th) percentile were randomly allocated to a very early (within 24 hours of birth) feeding regimen or delayed (after 24 hours of birth) feeding. All infants had in utero evidence of absent or reverse diastolic flow. Infants unable to start early feeding were excluded. Time-to-reach full feeding, feeding progression, and related morbidity were compared. Electrogastrography (EGG) was used to measure pre- and postprandial gastric motility on the second and seventh day after feeding initiation.
  
  
  RESULTS
  Sixty infants were included in the study, 30 in each group. Infants included in the very early feeding regimen achieved full enteral feeding sooner than controls (98±80-157 vs. 172±123-261 hours of age, respectively; p= 0.004) and were discharged home earlier (p=0.04). No necrotizing enterocolitis (NEC) was documented in both study groups. Gastric motility was improved at day seven after feeding initiation in both study groups, with no difference between groups.
  
  
  CONCLUSIONS
  Stable SGA preterm infants on a very early feeding regimen achieved full enteral feeding and were discharged home significantly earlier than those on a delayed regimen, with no excess morbidity.
authors.affiliation: Neonatal Department, Meir Medical Center, Kfar Saba, Israel. Faculty of Medicine, Sackler School of Medicine, Tel Aviv, Israel. shmuelar@clalit.org.il
authors.forename: Shmuel
authors.initials: S
authors.lastname: Arnon
authors.forename: Daniella
authors.initials: D
authors.lastname: Sulam
authors.forename: Fred
authors.initials: F
authors.lastname: Konikoff
authors.forename: Rivka H
authors.initials: RH
authors.lastname: Regev
authors.forename: Ita
authors.initials: I
authors.lastname: Litmanovitz
authors.forename: Timna
authors.initials: T
authors.lastname: Naftali
mesh_terms: D001724:Birth Weight / Q000502:physiology; D004576:Electromyography / Q000379:methods; D004750:Enteral Nutrition / Q000379:methods*; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology / Q000517:prevention & control*; D005769:Gastrointestinal Motility / Q000502:physiology*; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D019102:Infant, Very Low Birth Weight / Q000502:physiology*; D013997:Time Factors
keywords: Electrogastrography; Eletrogastrografia; Feeding; Neonatos com muito baixo peso ao nascer; Neonatos prematuros; Nutrição; Pequenos para a idade gestacional; Preterm infants; Small for gestational age; Very low birth weight infants