The available trial data suggest that advancing enteral feed volumes at daily increments of 30 ml/kg to 35 ml/kg does not increase the risk of necrotising enterocolitis in very preterm or VLBW infants .
Advancing the volume of enteral feeds at slow rates result ed in several days delay in regaining birth weight and establishing full enteral feeds .
The applicability of these findings to extremely preterm , extremely low birth weight , or growth-restricted infants is limited .
BACKGROUND Early enteral feeding practice s are potentially modifiable risk factors for necrotising enterocolitis  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 necrotising enterocolitis .
However , slow feed advancement may delay establishment of full enteral feeding and be associated with metabolic and infectious morbidities secondary to prolonged exposure to parenteral nutrition .
OBJECTIVES To determine the effect of slow rates of enteral feed advancement on the incidence of necrotising enterocolitis , mortality , and other morbidities in very preterm or VLBW infants .
Breast milk and neonatal necrotising enterocolitis
In a prospect i ve multicentre study on 926 preterm infants formally assigned to their early diet , necrotising enterocolitis developed in 51 ( 5.5 % ) .  Mortality was 26 % in stringently confirmed cases . In exclusively  formula-fed  babies confirmed disease was 6 - 10 times more common than in those fed breast milk alone and 3 times more common than in those who received formula plus breast milk . Pasteurised donor milk seemed to be as protective as raw maternal milk . Among babies born at more than 30 weeks ' gestation confirmed necrotising enterocolitis was rare in those whose diet included breast milk ; it was 20 times more common in those fed formula only . Other risk factors included very low  gestational age , respiratory disease , umbilical artery catheterisation , and polycythaemia . In formula-fed but not breast-milk-fed infants , delayed enteral feeding was associated with a lower frequency of necrotising enterocolitis . With the fall in the use of breast milk in British neonatal units , exclusive formula feeding could account for an estimated 500 extra cases of necrotising enterocolitis each year . About 100 of these infants would die
The available trial data suggest that advancing enteral feed volumes at daily increments of 30 ml/kg to 35 ml/kg does not increase the risk of necrotising enterocolitis in very preterm or VLBW infants .
Advancing the volume of enteral feeds at slow rates result ed in several days delay in regaining birth weight and establishing full enteral feeds .
The applicability of these findings to extremely preterm , extremely low birth weight , or growth-restricted infants is limited .
BACKGROUND Early enteral feeding practice s are potentially modifiable risk factors for necrotising enterocolitis  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 necrotising enterocolitis .
However , slow feed advancement may delay establishment of full enteral feeding and be associated with metabolic and infectious morbidities secondary to prolonged exposure to parenteral nutrition .
OBJECTIVES To determine the effect of slow rates of enteral feed advancement on the incidence of necrotising enterocolitis , mortality , and other morbidities in very preterm or VLBW infants .