The evidence available from r and omised controlled trials suggested that delaying the introduction of progressive enteral feeds beyond four days after birth did not reduce the risk of developing NEC in very preterm or VLBW infants , including growth-restricted infants .
Delaying the introduction of progressive enteral feeds result ed in a few days ' delay in establishing full enteral feeds but the clinical importance of this effect was unclear .
BACKGROUND The introduction of enteral feeds for very preterm ( less than 32 weeks ' gestation ) or very low birth weight ( VLBW ; less than 1500 g ) infants is often delayed for several days or longer after birth due to concern that early introduction may not be tolerated and may increase the risk of necrotising enterocolitis ( NEC ) .
However , delaying enteral feeding could diminish the functional adaptation of the gastrointestinal tract and prolong the need for parenteral nutrition with its attendant infectious and metabolic risks .
OBJECTIVES To determine the effect of delayed introduction of progressive enteral feeds on the incidence of NEC , mortality and other morbidities in very preterm or VLBW infants .
Feeding premature infants while low umbilical artery catheters are in place: a prospective, randomized trial.
OBJECTIVE The objective of this prospect i ve , r and omized clinical trial was to test the hypothesis that there is no difference in the frequency of feeding problems and necrotizing enterocolitis between a group of premature infants who received early enteral feedings while low umbilical artery catheters ( LUACs ) were in place , and a late group who were not fed until 24 hours after removal of LUACs .  PATIENTS AND METHODS Twenty-nine premature infants ( born at 28.5 + /- 3.0 SD weeks of gestational age ) who were in stable condition received early enteral feedings at a median of 2 days while a LUAC was in place ; 31 infants ( born at 28.6 + /- 2.7 SD weeks of gestational age ) received late enteral feedings at a median of 5 days of age , 24 hours after the removal of the LUAC . Feeding complications and interventions and nutritional characteristics were recorded prospect ively . RESULTS There were no differences in the baseline perinatal characteristics of the two groups . The incidence of gastric residua and the incidence of abdominal distention were the same in both groups . The early feeding group had significantly fewer percutaneous central venous catheters , evaluations for sepsis , and episodes of receiving nothing by mouth while a gastric suction tube was in place . Infants in the early group received parenteral alimentation-lipid emulsion infusions  for a median of 13 days versus 30 days for the late-fed group ( p = 0.0028 by Wilcoxon test ) . There were two cases of necrotizing enterocolitis in the early group versus four cases in the late group . CONCLUSIONS Premature infants in stable condition who receive enteral feedings while LUACs are in place do not have an increased incidence of feeding problems compared with infants who do not receive enteral feedings until 24 hours after removal of LUACs
The evidence available from r and omised controlled trials suggested that delaying the introduction of progressive enteral feeds beyond four days after birth did not reduce the risk of developing NEC in very preterm or VLBW infants , including growth-restricted infants .
Delaying the introduction of progressive enteral feeds result ed in a few days ' delay in establishing full enteral feeds but the clinical importance of this effect was unclear .
BACKGROUND The introduction of enteral feeds for very preterm ( less than 32 weeks ' gestation ) or very low birth weight ( VLBW ; less than 1500 g ) infants is often delayed for several days or longer after birth due to concern that early introduction may not be tolerated and may increase the risk of necrotising enterocolitis ( NEC ) .
However , delaying enteral feeding could diminish the functional adaptation of the gastrointestinal tract and prolong the need for parenteral nutrition with its attendant infectious and metabolic risks .
OBJECTIVES To determine the effect of delayed introduction of progressive enteral feeds on the incidence of NEC , mortality and other morbidities in very preterm or VLBW infants .