title: Proactive enteral nutrition in moderately preterm small for gestational age infants: a randomized clinical trial.
abstract: OBJECTIVE
  To investigate the efficacy of a proactive feeding regimen (PFR) in reducing hospital length of stay in a population of moderately preterm small for gestational age (SGA) infants.
  
  
  METHODS
  SGA infants (z-score <-1.28) of gestational age (GA) 32-36 weeks and birth weight (BW) >1499 g were allocated at random to receive either a PFR, starting with 100 mL/kg/day and gradually increasing to 200 mL/kg/day by day 4, or a standard feeding regimen, starting with 60 mL/kg/day and gradually increasing to 170 mL/kg/day by day 9. All infants received human milk.
  
  
  RESULTS
  A total of 72 infants were randomized to the 2 groups, 36 to the PFR group (mean GA, 35.1 ± 0.7 weeks; mean BW, 1761 ± 177 g) and 36 to the standard feeding regimen group (mean GA, 35.5 ± 1.2 weeks; mean BW, 1754 ± 212 g). Infants in the PFR group were discharged significantly earlier (mean, 9.8 ± 3.1 days vs 11.9 ± 4.7 days; P = .029). The need for intravenous fluids (2.8% vs 33.3%; P = .0013) and the incidence of hypoglycemia (0 vs 33.3%; P = .00016) were significantly lower in the PFR group. Feeding intolerance and fecal calprotectin levels did not differ between the 2 groups.
  
  
  CONCLUSIONS
  A PFR in moderately preterm SGA infants is well tolerated and significantly reduces both the length of stay and the risk of neonatal hypoglycemia.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Zecca
authors.affiliation: Division of Neonatology, Department of Pediatrics, Catholic University of the Sacred Heart, Rome, Italy. Electronic address: simocosta@yahoo.it.
authors.forename: Simonetta
authors.initials: S
authors.lastname: Costa
authors.affiliation: Division of Neonatology, Department of Pediatrics, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Barone
authors.affiliation: Division of Neonatology, Department of Pediatrics, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Giordano
authors.affiliation: Division of Neonatology, Department of Pediatrics, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Zecca
authors.affiliation: Division of Neonatology, Department of Pediatrics, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Maggio
mesh_terms: D004750:Enteral Nutrition / Q000379:methods*; D005317:Fetal Growth Retardation / Q000628:therapy; D005865:Gestational Age; D006801:Humans; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000628:therapy*; D007236:Infant, Small for Gestational Age; D007902:Length of Stay; D008895:Milk, Human; D011446:Prospective Studies