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 .
Does necrotising enterocolitis impact the neurodevelopmental and growth outcomes in preterm infants with birthweight < or =1250 g?
AIM To compare the long-term growth and neurodevelopmental outcomes at 36 months adjusted age in preterm infants ( birthweight ( BW ) < or = 1250 g ) with necrotising enterocolitis ( NEC ) with BW-matched controls . METHODS This is a case control study performed at a regional tertiary care neonatal intensive care unit . Infants with stage II or III NEC admitted to a regional tertiary care neonatal unit between 1995 and 2000 were identified . Each infant with NEC was matched by BW ( + /-100 g ) to next two infants admitted in the unit without NEC . Growth and neurodevelopmental outcomes at 36 months are compared . RESULTS In total , 51 infants with NEC and 102 controls met study eligibility criteria and 146/153 ( 94.3 % ) were prospect ively followed for 36 months . Infants with NEC had more culture-proven sepsis ( 35.3 % vs. 10.8 % , P < 0.001 ) ; patent ductus arteriosus requiring therapy ( 64.7 % vs. 45 % , P = 0.02 ) , chronic lung disease ( 60.7 % vs. 45 % , P = 0.04 ) and longer hospital stay ( 84 days vs. 71 days , P < 0.0001 ) . There were no significant differences in growth outcomes between the two groups at 36 months . Overall 24 % of infants with NEC had one major neurodevelopmental disability compared with 10 % among control infants . Infants who developed NEC had significantly higher cognitive delay ( i.e. cognitive index < 70 ) and visual impairment . A logistic regression model identified NEC as a predictor of cognitive delay . CONCLUSION Preterm infants who develop NEC are at a significantly higher risk for developing neurodevelopmental disability . We recommend close neurodevelopmental follow up for all < or = 1250 g infants who develop stage II or III 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 .