2 hourly versus 3 hourly feeding schedule in very low birth weight preterm neonates

Abstract

Objective: Very low birth weight (VLBW) preterm neonates are fed every 2 hourly (2H) or 3 hourly (3H), but there is not sufficient evidence to determine the best feeding schedule. The study objectives were to compare the effects of 2H or 3H feeding schedule in neonates weighing <1500 g at birth, on the incidence of feed intolerance, apnea, necrotizing enterocolitis (NEC), hypoglycemia, and time to attain full feeds. Design and Setting: This longitudinal observational study was conducted in a level III neonatal unit of a teaching hospital in North India between October 2012 and March 2014. Materials and Methods: All stable intramural neonates born <1500 g were eligible for the study. Neonates with major malformations, congenital heart diseases, gastrointestinal anomalies, and those contraindicated for enteral feeding as decided by the treating clinicians were excluded. Sixty VLBW preterm neonates were assigned to 2H or 3H feeding groups. The incidence of feed intolerance, apnea, NEC, hypoglycemia, and time to attain full feeds was assessed. Results: There was no difference in incidence of feed intolerance between the two groups (30% vs. 23.3%, P = 0.56). The incidence of apnea, NEC, hypoglycemia, and time to attain full feeds was also similar between the two groups. Conclusion: 3H feeding is possibly as good as 2H feedings for VLBW neonates.