Available trial data do not provide evidence that advancing enteral feed volumes at daily increments of 15 to 20 mL/kg ( compared with 30 to 40 mL/kg ) reduces the risk of NEC or death in very preterm or VLBW infants , extremely preterm or ELBW infants , SGA or growth-restricted infants , or infants with antenatal AREDFV .
Advancing the volume of enteral feeds at a slow rate results in several days of delay in establishing full enteral feeds and may increase the risk of invasive infection
BACKGROUND Early enteral feeding practice s are potentially modifiable risk factors for necrotising enterocolitis ( NEC ) in very preterm or very low birth weight ( VLBW ) infants .
Observational studies suggest that conservative feeding regimens , including slowly advancing enteral feed volumes , reduce the risk of NEC .
However , slow feed advancement may delay establishment of full enteral feeding and may be associated with metabolic and infectious morbidities secondary to prolonged exposure to parenteral nutrition .
OBJECTIVES To determine effects of slow rates of enteral feed advancement on the incidence of NEC , mortality , and other morbidities in very preterm or VLBW infants .
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 . Design Parallel-group r and omised controlled trial with a 1:1 allocation ratio . Setting Two regional tertiary neonatal intensive care units . Patients 150 preterm infants less than 35 weeks gestation with birth weight between 1.0 and 1.5 kg were recruited . Interventions Infants were enrolled to either 2-hourly or 3-hourly interval feeding after r and omisation . Blinding was not possible due to the nature of the intervention . Main outcome measures 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 . Conclusion 3-hourly feeding was comparable with 2-hourly feeding to achieve full enteral feeding without any evidence of increased adverse events . Trial registration number ACTRN12611000676910 , pre- result
Available trial data do not provide evidence that advancing enteral feed volumes at daily increments of 15 to 20 mL/kg ( compared with 30 to 40 mL/kg ) reduces the risk of NEC or death in very preterm or VLBW infants , extremely preterm or ELBW infants , SGA or growth-restricted infants , or infants with antenatal AREDFV .
Advancing the volume of enteral feeds at a slow rate results in several days of delay in establishing full enteral feeds and may increase the risk of invasive infection
BACKGROUND Early enteral feeding practice s are potentially modifiable risk factors for necrotising enterocolitis ( NEC ) in very preterm or very low birth weight ( VLBW ) infants .
Observational studies suggest that conservative feeding regimens , including slowly advancing enteral feed volumes , reduce the risk of NEC .
However , slow feed advancement may delay establishment of full enteral feeding and may be associated with metabolic and infectious morbidities secondary to prolonged exposure to parenteral nutrition .
OBJECTIVES To determine effects of slow rates of enteral feed advancement on the incidence of NEC , mortality , and other morbidities in very preterm or VLBW infants .