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 .
Predischarge morbidities in extremely and very low-birth-weight infants in Spanish neonatal units.
We sought to describe neonatal morbidities and therapeutic interventions in very low-birth-weight ( VLBW ) and extremely low-birth-weight ( ELBW ) infants cared for in Spanish hospitals . We preformed a prospect i ve collection of data covering the perinatal period until discharge by the SEN1500 network . This network , set up by the Spanish Society of Neonatology , targets VLBW and ELBW infants ( 400 to 1500 g ) admitted to neonatal units in Spanish hospitals . Data were recorded in electronic form and controlled for possible errors or inconsistencies before analysis . We report data for 8836 neonates admitted to 48 neonatal units from January 2002 to December 2005 .  Prenatal steroids were given to significantly more newborns in 2003 to 2005 ( 79.4 % ) than in 2002 ( 73.4 % ) , although the remaining perinatal data examined failed to significantly vary . Delivery was by cesarean section in 69.8 % of cases but significantly lower ( 35.9 % ) for infants under a postmenstrual age of 26 weeks . Hyaline membrane disease was diagnosed in 53.9 % of the newborns and bronchopulmonary dysplasia ( BPD ) in 10.46 % .  Mechanical ventilation  was employed in 69.1 % , surfactant in 50.3 % , and steroids for BPD in 5.3 % . Intraventricular hemorrhage grade s 3 to 4 ( 8.1 % ) and cystic leukomalacia ( 2.6 % ) were the most relevant brain ultrasonography findings . Rates of early- and late-onset septicemia were 5 % and 29.4 % , respectively . Further diagnoses were necrotizing enterocolitis ( NEC ; 6.9 % ) and persistent ductus arteriosus ( PDA ; 24.2 % ) ; 40.6 % of the cases of NEC and 15.3 % of those of PDA required surgery . In addition , 26.6 % of the newborns required supplementary oxygen at 28 days of life . The number of newborns who had not recovered their birth weight at this age fell from 3.1 % in 2002 to 1.5 % in 2005 . Rates of prenatal steroid use , cesarean delivery , and main morbidities were comparable to figures cited for other patient series , although our BPD rate was among the lowest reported and nosocomial sepsis rate among the highest
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 .