Gradual advancement of enteral feeding in preterm newborns: preliminary results of a multicenter prospective randomized study
Authors:   Academician V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation, Ionov O.I. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Kosterina E.E. ,   Academician V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation, Kirtbaya A.R. ,   Academician V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Balashova E.N. ,   Academician V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation, Krasnyi A.M. ,   Academician V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation, Petrova A.S. ,   Moscow Regional Perinatal Center, Balashikha, Russian Federation, Grusynova A.S. ,   Moscow Regional Perinatal Center, Balashikha, Russian Federation, Obrubov D.I. ,   Moscow Regional Perinatal Center, Balashikha, Russian Federation, Мalyutina L.V. ,   Moscow Regional Perinatal Center, Balashikha, Russian Federation, Serova O.F. ,   Moscow Regional Perinatal Center, Balashikha, Russian Federation, Zubkov V.V. ,   Academician V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
Published: April 2022

Objective. To assess safety and effectiveness of gradual advancement of enteral feeding in preterm newborns with a gestational age of ≤32 weeks and compare it with conventional feeding strategy. Patients and methods. This multicenter prospective randomized study is still ongoing in V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia and Moscow Regional Perinatal Center. This pilot study included 36 patients with a gestational age of 28/0-32/6 weeks and birth weight 836 g to 2210 g treated in these two institutions between June and December 2020. Study participants were randomly assigned to either experimental or control group. Newborns in the experimental group received enteral nutrition with gradual advancement at each feeding, while newborns in the control group were fed according to a standard scheme with the advancement made twice a day. The daily rate of enteral feeding advancement was 30 ml/kg/day. Results. Gradual advancement of enteral feeding in the experimental group (n = 17) allowed its participants to reach the targeted daily volumes of 100 and 160 mL/kg faster than controls (n = 19) without any increase in the incidence of necrotizing enterocolitis and gastrointestinal dyskinesia. This ensured shorter (1.5 times) duration of central venous catheter use and length of stay in the intensive care unit among newborns with a birth weight <1500 g. Conclusion. Preliminary results of our study suggest safety and effectiveness of gradual advancement of enteral feeding compared to traditional feeding strategy in newborns with a gestational age of 28/0-32/6 weeks. Since our sample was rather small, the benefits and safety of gradual feeding advancement should be further investigated. Key words: preterm newborn, enteral nutrition, feeding, very low birth weight, extremely low birth weight, necrotizing enterocolitis