Early progressive feeding ups number of full enteral feeding days in extremely preterm infants
Early progressive feeding is feasible and effective in increasing the number of full enteral feeding days in extremely preterm infants, suggests a recent study.
A total of 60 infants (median gestation age, 26 weeks; mean birth weight, 832 g) were included. The number of full enteral feeding days in the first month after birth differed between groups (median difference favouring the early feeding group: 2 days; 95 percent CI, 0–3 days; p=0.02). In addition, the use of parenteral nutrition (4 vs 8 days; p≤0.01) and the need for central venous access (9 vs 13 days; p≤0.01) decreased with early progressive feeding.
There was no between-group difference in the outcome of culture-proven sepsis (10 percent vs 27 percent; p=0.18), restricted growth (weight, length and head circumference <10th percentile) at 36-week postmenstrual age (25 percent vs 50 percent; p=0.07) and the composite outcome of necrotizing enterocolitis (NEC) or death (27 percent vs 20 percent; p=0.74).
This single-centre study randomized extremely preterm infants (≤28 weeks of gestation) born between September 2016 and June 2017 to receive either early progressive feeding without trophic feeding (early feeding group) or delayed progressive feeding after a 4-day course of trophic feeding (delayed feeding group). Treatment was allocated on or before feeding day 1.
The primary outcome was the number of full enteral feeding days in the first month after birth, and secondary outcomes included death, NEC, culture-proven sepsis, growth percentiles at 36-week postmenstrual age, use of parenteral nutrition and need for central venous access.
“Due to insufficient evidence, extremely preterm infants rarely receive early progressive feeding (small increments of feeding volumes between 1 and 4 days after birth),” researchers said. “We hypothesized that early progressive feeding increases the number of full enteral feeding days in the first month after birth.”