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 .
[Necrotizing enterocolitis among preterm newborns with early feeding].
INTRODUCTION The development of necrotizing enterocolitis is a common and serious risk to newborns . It is caused by splanchnic bed vasoconstriction that can produce intestinal necrosis . The role of onset time , type and , speed enhancements of The factors of enteral feeding related with necrotizing enterocolitis genesis such as feeding onset , type and frequency are not well understood . OBJECTIVE The incidence of necrotizing enterocolitis and mortality among infants will be compared in infants whose enteral feeding was initiated 48 hours after birth to those whose feeding began on day 5 postpartum . MATERIAL S AND METHODS A controlled clinical trial was conducted among 239 newborns weighing between 750 - 1,500 g and a gestation age of 27 - 32 weeks of gestational age . The infants were r and omly assigned to two groups--135 to an early feeding regime and 104 to delayed feeding . Breast milk or formula milk was used . Feeding was begun with one ml every six hours , progressing to three hour intervals and 20 ml/kg daily . This was increased to 150 ml/kg-d if the infant condition remained stable and it manifested no oral intolerance . RESULTS In the early feeding group , 14 ( 10;4 % ) necrotizing enterocolitis cases occurred , and in the late feeding group , 9 ( 8.7 % ) occurred ( RR= 1.22 , 95 % CI 0.49 - 3.20 , p= 0.65 ) . Five children died in early feeding group ( 3.7 % , 95 % CI 1.4 - 8.9 ) and eight in late feeding group ( 7.7 % , 95 % CI 3.6 - 15.0 , RR=0.46 , 95 % CI 0.12 - 1,60 , p= 0.18 ) . CONCLUSION Early enteral feeding in preterm newborns does not increase the risk of necrotizing enterocolitis or mortality among them ; however it represents nutritional advantages for these infants
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 .