The available data do not provide evidence of any beneficial effect of transpyloric feeding for preterm infants. Some evidence of harm exists, including a higher risk of gastrointestinal disturbance and mortality, but these findings should be interpreted and applied cautiously because of methodological weaknesses in the included trials.
Poor weight gain of the low birthweight infant fed nasojejunally.
Forty-four appropriately grown preterm infants of birthweight 1-1.5 kg were allocated to nasojejunal (NJ) or nasogastric (NG) feeding at birth. Infants in the NJ group were transferred to NG feeding as soon as they weighed 1.5 kg. The mean caloric intake of infants in both groups was the same, but mean incremental weight velocity during NJ feeding was significantly less than during NG feeding. At expected date of delivery mean body weight and mean occipitofrontal circumference were significantly smaller in the NJ group. During the 3 months after the expected date of delivery, when all infants were being fed orally, the infants in the NJ group had significantly greater mean weight velocity and mean occipitofrontal circumference velocity than infants in the NG group so that by 3 months after the expected date of delivery there was no significant difference in bodyweight or occipitofrontal circumference between the groups. Low birthweight infants fed by the nasojejunal route from birth should be transferred to nasogastric feeding as soon as possible.