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 .
The significance of gastric residuals in the early enteral feeding advancement of extremely low birth weight infants.
OBJECTIVE To evaluate whether the mean gastric residual volume ( GRV ) and green gastric residuals ( GR ) themselves are significant predictors of feeding intolerance in the early enteral feeding advancement in extremely low birth weight ( ELBW ; < 1000 g ) infants . DESIGN Ninety-nine ELBW infants were fed following a st and ardized protocol ( day 3 - -14 ) . At 48 hours of age , milk feeding was started ( 12 mL/kg/d increments , 12 meals per day ) . GR were checked before each feeding , and a GRV up to 2 mL/3 mL in infants less-than-or-equal750 g/>750 g was tolerated . In cases of increased GRV , feedings were reduced or withheld . The color of GR was assessed as clear , milky , green-clear , green-cloudy , blood-stained , or hemorrhagic . Multiple regression analysis was used to study the effect of the mean GRV and the color of GR on the feeding volume on day 14 ( V14 ) . RESULTS The median V14 was 103 mL/kg/d ( 0 - -166 ) . V14 increased with an increasing percentage of milky GR , whereas the mean GRV and the color green did not have a significant effect . CONCLUSIONS 1 ) Early enteral feeding could be established in ELBW infants . The critical GRV seems to be above 2 mL/3 mL because there was no significant negative correlation between the mean GRV and V14 . 2 ) Green GR were not negatively correlated with V14 and should not slow down the advancement of feeding volumes in absence of other clinical signs and symptoms
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 .