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 trial of "slow" versus "fast" feed advancements on the incidence of necrotizing enterocolitis in very low birth weight infants.
OBJECTIVE To determine whether the rate of feed advancement affects the incidence of necrotizing enterocolitis ( NEC ) . STUDY DESIGN Prospect i ve r and omized controlled trial involving 185 formula-fed infants with birth weight 501 to 1500 g and gestational age < /=34 weeks . Infants were r and omized into 2 groups : " slow " ( n = 98 ) , who received 15 cc/kg/d increments ( a 10-day schedule to full feeds ) and " fast " ( n = 87 ) , who received 35 cc/kg/d increments ( a 5-day schedule to full feeds ) of Similac Special Care 20 cal/oz . Feeds were increased only if well tolerated as defined by a protocol . RESULTS The incidence of NEC ( Bell stage > /=II ) was similar in both groups ( slow 13 % and fast 9 % , P = .5 ) . The incidence of perforation ( Bell stage III ) was also similar in both groups ( slow 4 % and fast 2 % , P = .8 ) . Feeds were started at a comparable postnatal age in both groups ( median age : slow 5 days and fast 4 days , P = .9 ) . Although the neonates in the fast group attained full enteral intake earlier ( median days [ 25th and 75th percentiles ] : slow 15 [ 12 , 21 ] and fast 11 [ 8 , 15 ] , P < .001 ) and regained their birth weight earlier ( slow 15 [ 11 , 20 ] and fast 12 [ 8 , 15 ] , P < .05 ) , their ages at discharge were not statistically different ( slow 47 [ 31 , 67 ] and fast 43 [ 29 , 62 ] , P = .3 ) CONCLUSIONS A greater than twofold difference in the rate of feed advancement from 15 cc/kg/d to 35 cc/kg/d did not affect the incidence of NEC > /= stage II . Factors other than feed advancement appear to be more important in the pathogenesis or progression of NEC
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 .