Impact of Feeding Interval of Preterms on the Time of Transition From Tube Feeding to Oral Feeding

Study Overview
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Brief Summary
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Preterms are usually fed with intervals of either two or three hours during their stay in neonatal intensive care unit. Recommendations of World Health Organization about feeding regimens, 3-hourly for infants 1500 - 2000 gr, and 2-hourly for infants 1000 - 1500 gr, are not proposed with regards to results of randomized controlled trials. Investigators aimed to investigate the impact of 2-hourly feeding on time of transition from orogastric to oral feeding.

Detailed Description
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Preterms are usually fed with intervals of either two or three hours during their stay in neonatal intensive care unit. Recommendations of World Health Organization about feeding regimens, 3-hourly for infants 1500 - 2000 gr, and 2-hourly for infants 1000 - 1500 gr, are not proposed with regards to results of randomized controlled trials. Stomach volume of preterms varies a wide range of upto 20 ml. This should be taken into consideration during the process of feeding of preterms in neonatal intensive care unit. Trials were focused on early neonatal outcomes and it was found that duration of phototherapy and nasal noninvasive ventilation, and time to achieve full enteral feeds were shorter during 2-hourly feeding when compared to 3-hourly feeding, on the other hand 3-hourly feeding was shown to accelerate the stomach emptying. Besides, duration of catheterization, and ratio of feeding intolerance, apnea, and hypoglycemia were found to be similar infants who fed either 2 or 3-hourly. Investigators aimed to investigate the impact of two feeding regimens, 2-hourly or 3-hourly, on time of transition from orogastric to oral feeding in preterms. Patients and Methods: Preterms of birth weight less that 1500 gr and gestational age smaller than 32 weeks are going to be eligible for study if no congenital anomalies exist. Regarding current clinical protocol infants are fed every 2 hours until they weigh 1500 gr, and every 3 hours afterwards. At the day that the infants reach 1500 gr of body weight, a randomization will be performed in to two groups, Intervention group: Q2 interval (2-hourly feeding) or Control group: Q3 interval (3-hourly feeding), due to study protocol. Infants with inherited metabolic disorders, congenital anomalies, neonatal sepsis, and surgical diseases and the ones who fed with exclusively formula will be excluded. After randomization infants will be followed until discharge. The type of feeding, volume of each feed, weight gain per week, feeding intolerance (abdominal distention, vomiting, apnea, newly onset or increase of oxygen treatment demand), day of first oral feeding, time of transition from orogastric tube to oral feeding, duration of hospitalization will be recorded.

Official Title
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Impact of Feeding Interval of Preterms on the Time of Transition From Tube Feeding to Oral Feeding

Conditions
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Bottlefeeding, Infant, Premature, Diseases

Intervention / Treatment
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* Other: Q2 feeding


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: birth weight <= 1500 gr gr gestational age <= 32 weeks postnatal age at randomization: between 7 - 90 days Exclusion Criteria: congenital anomaly multi organ failure sepsis surgical pathology inherited metabolic diseases exclusively formula feeding

Ages Eligible for Study
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Minimum Age: 7 Days
Maximum Age: 90 Days

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Q2 feeding<br>feeding intervals: 2 hours | Other: Q2 feeding<br>* Infants are going to be fed every 2 hours<br>|
| No Intervention: Q3feeding<br>feeding intervals: 3 hours | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| time of transition from orogastric to oral feeding |  | From date of birth to date of transition from orogastric to oral feeding or date of death, which ever came first, will be assessed up to 44th post menstrual age (days of life) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| feeding intolerance after randomization; intolerance events per week until discharge |  | From date of randomization to date of discharge or date of death, which ever came first, will be assessed up to 44th post menstrual age | 
| duration of hospitalization |  | From date of birth to date of discharge or date of death, which ever came first, will be assessed up to 44th post menstrual age, (days of life) | 
| weight gain per week until discharge |  | From date of randomization to date of discharge or date of death, which ever came first, will be assessed up to 44th post menstrual age, (grams/kg/week) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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preterm, feeding, oral transition