Two-hourly versus 3-hourly feeding for very low birthweight infants: a randomised controlled trial.
OBJECTIVE
To determine whether feeding with 2-hourly or 3-hourly feeding interval reduces the time to achieve full enteral feeding and to compare their outcome in very low birthweight preterm infants.


METHODS
Parallel-group randomised controlled trial with a 1:1 allocation ratio.


METHODS
Two regional tertiary neonatal intensive care units.


METHODS
150 preterm infants less than 35 weeks gestation with birth weight between 1.0 and 1.5 kg were recruited.


METHODS
Infants were enrolled to either 2-hourly or 3-hourly interval feeding after randomisation. Blinding was not possible due to the nature of the intervention.


METHODS
The primary outcome was time to achieve full enteral feeding (≥100 mL/kg/day). Secondary outcomes include time to regain birth weight, episode of feeding intolerance, peak serum bilirubin levels, duration of phototherapy, episode of necrotising enterocolitis, nosocomial sepsis and gastro-oesophageal reflux.


RESULTS
72 infants were available for primary outcome analysis in each group as three were excluded due to death-three deaths in each group. The mean time to full enteral feeding was 11.3 days in the 3-hourly group and 10.2 days in the 2-hourly group (mean difference 1.1 days; 95% CI -0.4 to 2.5; p=0.14). The mean time to regain birth weight was shorter in 3-hourly group (12.9 vs 14.8 days, p=0.04). Other subgroup analyses did not reveal additional significant results. No difference in adverse events was found between the groups.


CONCLUSIONS
3-hourly feeding was comparable with 2-hourly feeding to achieve full enteral feeding without any evidence of increased adverse events.


BACKGROUND
ACTRN12611000676910, pre-result.
Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
Nor Rosidah
http://orcid.org/0000-0002-9576-8017
NR
Ibrahim
Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
Tan Hooi
TH
Kheng
Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
Ariffin
http://orcid.org/0000-0002-4878-9739
A
Nasir
Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
Noraida
N
Ramli
Department of Paediatrics, Hospital Sultanah Nur Zahirah, Kuala Terengganu, Terengganu, Malaysia.
Jimmy Lee Kok
JLK
Foo
Department of Paediatrics, Hospital Sultanah Nur Zahirah, Kuala Terengganu, Terengganu, Malaysia.
Sharifah Huda
SH
Syed Alwi
Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
Hans
H
Van Rostenberghe
D001724:Birth Weight; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D015931:Intensive Care, Neonatal / Q000379:methods*; D008297:Male; D010288:Parenteral Nutrition / Q000009:adverse effects / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome
Infant Feeding; Neonatology