The identified trials provide only low quality evidence about the effects of feeding preterm infants  with protein hydrolysate versus st and ard formula .
The existing data did not support conclusions that feeding with protein hydrolysate affects the risk of feed intolerance or necrotising enterocolitis .
BACKGROUND When human milk is not available for feeding preterm infants , protein hydrolysate rather than st and ard cow 's milk formulas ( with intact proteins ) are often used because they are perceived as being tolerated better and less likely to lead to complications .
However , protein hydrolysate formulas are more expensive than st and ard formulas , and concern exists that their use in practice is not supported by high- quality evidence .
OBJECTIVES To assess the effect of feeding preterm infants with hydrolysed formula ( versus st and ard cow 's milk formulas )  on the risk of feed intolerance , necrotising enterocolitis , and  other morbidity and mortality in preterm infants .
Hydrolyzed protein accelerates feeding advancement in very low birth weight infants.
BACKGROUND Feeding intolerance is common in very low birth weight ( VLBW ; < 1500 g ) infants .  Hydrolyzed protein preterm infant formula ( HPF ) has been shown to accelerate the gastrointestinal transit of formula . The aim of this study was to investigate whether HPF improves early feeding tolerance compared with st and ard preterm infant formula ( SPF ) . We hypothesized that HPF would accelerate early enteral feeding advancement . METHODS Primary outcome was the time from initiation of milk feeds until full feeds ( 150 mL/kg birth weight/d ) were achieved in infants who received < 10 % human milk ( HM ) to exclude HM as a confounder . Because the availability of HM was not predictable at the time of enrollment , all eligible VLBW infants ( n = 129 ) were r and omly assigned in a r and omized , controlled trial to receive HPF or SPF if HM was not available . Infants who received > 10 % HM ( n = 42 ) were excluded . Milk bolus feeding every 2 to 3 hours was started at the discretion of the attending physician and advanced by 16 mL/kg/d . Prepr and ial gastric residuals were tolerated up to 5 mL/kg ; otherwise , feedings were reduced or withheld . Data are shown as median ( 5th and 95th percentile ) . RESULTS Forty-six and 41 ( HPF vs SPF ) infants received < 10 % HM . There was no significant difference with regard to birth weight , gestational age , and onset of milk feeds ( day 3 [ 1 - 8 ] vs 4 [ 2 - 6 ] ) . The time from initiation of milk feeds to full feeds was significantly shorter with HPF feeding ( 10 [ 9 - 27 ] vs 12 [ 9 - 28 ] days ) . CONCLUSION HPF improved the feeding tolerance and enabled a more rapid establishment of full enteral feeding in VLBW infants compared with SPF
The identified trials provide only low quality evidence about the effects of feeding preterm infants  with protein hydrolysate versus st and ard formula .
The existing data did not support conclusions that feeding with protein hydrolysate affects the risk of feed intolerance or necrotising enterocolitis .
BACKGROUND When human milk is not available for feeding preterm infants , protein hydrolysate rather than st and ard cow 's milk formulas ( with intact proteins ) are often used because they are perceived as being tolerated better and less likely to lead to complications .
However , protein hydrolysate formulas are more expensive than st and ard formulas , and concern exists that their use in practice is not supported by high- quality evidence .
OBJECTIVES To assess the effect of feeding preterm infants with hydrolysed formula ( versus st and ard cow 's milk formulas )  on the risk of feed intolerance , necrotising enterocolitis , and  other morbidity and mortality in preterm infants .