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 .
Minimal enteral feeding within 3 d of birth in prematurely born infants with birth weight < or = 1200 g improves bone mass by term age.
BACKGROUND Evidence -based practice guidelines for aggressive nutritional intervention by using parenteral amino acids ( AAs ) and minimal enteral feeding ( MEF ) as early as the first day of life have not been tested for benefits to bone mass . OBJECTIVE We investigated whether early introduction of parenteral AAs and MEF improves growth and bone mass achieved by term age in infants born prematurely . DESIGN Twenty-seven infants who were < or = 1200 g and < or = 32 wk gestation at birth were r and omly assigned by using a 2 x 2 design to treatment of either 1 g AAs/kg within the first 24 h or 12 mL MEF x kg(-1 ) x d(-1 ) within the first 72 h of life . Nutrition and growth were documented during hospitalization , and bone mineral content ( BMC ) of lumbar spine 1 - 4 , femur , and whole body was measured at term age . Biomarkers of bone metabolism were measured at weeks 1 , 3 , and 5 and at discharge . Statistical analysis was conducted by using 2 x 2 analysis of variance for intent to treat and for infants receiving protocol nutrition . RESULTS Over the first 14 d of life , a main effect of early AAs elevated total intake of protein , and a main effect of early MEF was a higher frequency of MEF volumes exceeding > 12 mL x kg(-1 ) x d(-1 ) . Main effects on growth were not evident . An interaction effect was observed for osteocalcin whereby early AAs or MEF alone elevated osteocalcin . A main effect of early MEF yielded higher BMC of spine and femur . CONCLUSION Early aggressive nutrition support with MEF enhances BMC in premature infants , but early MEF or AAs do not improve growth
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 .