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 .
Randomized Controlled Trial on Effect of Intermittent Early Versus Late Kangaroo Mother Care on Human Milk Feeding in Low-Birth-Weight Neonates
Background : Breastfeeding at discharge among sick low-birth-weight ( LBW ) infants is low despite counseling and intervention like kangaroo mother care ( KMC ) . Research aim : The aim was to study the effects of early initiation of KMC on exclusive human milk feeding , growth , mortality , and morbidities in LBW neonates compared with late initiation of KMC during the hospital stay and postdischarge . Methods : A r and omized controlled trial was conducted in level 2 and 3 areas of a tertiary care neonatal unit over 15 months . Inborn neonates weighing 1 to 1.8 kg and hemodynamically stable were r and omized to receive either  early KMC , initiated within the first 4 days of life , or late KMC ( off respiratory support and intravenous fluids ) . Follow-up was until 1 month postdischarge . Outcomes were proportion of infants achieving exclusive human milk feeding and direct breastfeeding , growth , mortality and morbidities during hospital stay , and postdischarge feeding and KMC practice s until 1 month . Results : The early  KMC  group ( n = 80 ) achieved significantly higher exclusive human milk feeding ( 86 % vs. 45 % , p < .001 ) and direct breastfeeding ( 49 % vs. 30 % , p = .021 ) in hospital and almost exclusive human milk feeding ( 73 % vs. 36 % , p < .001 ) until 1 month postdischarge than the late KMC group ( n = 80 ) . The incidence of apnea ( 11.9 % vs. 20 % , p = .027 ) and recurrent apnea requiring ventilation ( 8.8 % vs. 15 % , p = .02 ) were significantly reduced in the early KMC group . There was no significant difference in mortality , morbidities , and growth during the hospital stay and postdischarge . Conclusion : Early KMC significantly increased exclusive human milk feeding and direct breastfeeding in LBW infants
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 .