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 .
Continuous feeding promotes gastrointestinal tolerance and growth in very low birth weight infants.
OBJECTIVE To compare the effects of continuous versus intermittent feeding on gastrointestinal tolerance and growth in very low birth weight ( VLBW ) infants . STUDY DESIGN In a r and omized , controlled trial conducted at 3 neonatal units , 70 premature infants with a gestational age 24 to 29 weeks and birth weight < 1200 g were assigned to 1 of 3 feeding methods : continuous nasogastric feeding , intermittent nasogastric feeding , or intermittent orogastric feeding . Feeding was initiated within 30 hours of birth . Daily enteral and parenteral volumes , caloric and protein intakes , growth , enteral intolerance , and clinical complications were recorded . Cox regression analysis was used to determine primary outcome , the time to achieve full enteral feeding . RESULTS The continuously fed infants achieved full enteral feeding significantly faster than the intermittently fed infants ( hazard ratio [ HR ] = 1.86 ; 95 % confidence interval [ CI ] = 1.07 to 3.22 ) . In stratified analysis according to birth weight , the improvement was even more pronounced in the smallest infants , those with birth weight < or = 850 g ( adjusted HR = 4.13 ; 95 % CI = 1.48 to 11.53 ) . Growth rate was significantly faster in the continuously fed infants ( P = .002 ) . CONCLUSION In VLBW infants , continuous feeding seems to be better than intermittent feeding with regard to gastrointestinal tolerance and growth
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 .