659 POOR WEIGHT GAIN IN JEJUNALLY FED LOW BIRTHWEIGHT (LBW) INFANTS

Abstract

Several studies have suggested that LBW infants fed by the nasojejunal (NJ) route gain weight more rapidly than those fed nasogastrically (NG), despite greater fat malabsorption during NJ feeding.* 40 appropriately grown LBW infants (mean birth weight 1.29 kg, range 1.04-1.49 kg; mean gestational age 29.6 weeks) were allocated to continuous NJ or intermittent NG feeding at birth and their growth followed till 6 months after expected date of delivery (EDD+6 months). Infants in the NJ group were transferred to NG feeding when they reached 1.5 kg body-weight. Although mean (±1SD) enteral caloric intake in the two groups was comparable (NJ 121.3±11.0; NG 121.7±9.6 cal/kg/day) mean (±1SD) weight velocity during NJ feeding (11.4±3.6) was less than during NG feeding (15.8±3.5 gm/kg/day, p=0.02), and bodyweight at EDD was lower in the NJ group (mean weight index ±1SD; NJ group 0.89±0.04; NG group 0.92±0.04; p<0.05). After transfer to NG feeding, infants in the NJ group grew more rapidly from EDD to EDD+3 months (mean weight velocity ±1SD; NJ group 7.69±1.57, NG group 6.49±1.59 gm/kg/day; p<0.05) so that at EDD+3 months and EDD+6 months there was no significant difference in bodyweight between the two groups. Because of poorer weight gain during NJ feeding, LBW infants fed by this route from birth should be transferred from NJ feeding as soon as an adequate enteral calorie intake can be tolerated by the NG route. *Roy et al (1977) J Peds 90:431.