A prospective randomized trial comparing intermittent nasoduodenal with intermittent nasogastric feedings in premature infants

Abstract

Objective To compare and evaluate the effects of intermittent nasoduodenal feeding (INDF) and intermittent nasogastric feeding (INGF) on nutrient intake, physical growth, gut transit time and whole gastrointestinal transit time and feeding related complications at the early time after birth in premature infants Methods Forty premature infants (birth weights ranged from 1 050 g to 1 920 g) were randomized into INDF and INGF groups and fed with the same formula Intake of fluid (including both intravenous and oral), caloric intake, protein intake, variation of physical growth parameters (e g, body weight, length and head circumference), stool characters, and relevant complications were recorded; gut transit time and whole gastrointestinal transit time were monitored Results Within a week after feeding, milk input was (67 2±38 8) ml/(kg·d), (55 7±36 6) ml/(kg·d), respectively, in INDF and INGF groups The caloric intake and the protein intake supplied by milk were (217 1±125 5) kJ/(kg·d) vs (188 7±126 4) kJ/(kg·d) and (1 62±0 9) g/(kg·d) vs (1 22±0 82) g/(kg·d) The nutrient intake in INDF group was significantly higher than that in INGF group ( P 0 001) The time of reaching 418 4 kJ/(kg·d) by enteral feeding were respectively (9 3±1 9) d and (13 9±7 4) d , the birth weight regaining time were (8 4±1 8) d vs (10 2±2 5) d; all these parameters in INDF group were significantly lower than those in INGF group ( P 0 05) There was no significant difference in the increase of length and head circumference between the two groups ( P 0 05) The gut transit time [INDF, (53 3±14 0) h] was significantly shorter than the whole gastrointestinal transit time [INGF, (63 2±14 9) h], but there was no such complications as diarrhea, in the two groups The morbidities of such complications as apnea and pneumonia caused by aspiration, vomiting, gastric residue were lower in INDF group than those in INGF group, but the difference was not statistically significant ( P 0 05) However, the morbidity of hyperbilirubinemia was significantly lower in INDF than that in INGF group ( P 0 01) Conclusion Nasoduodenal feeding was more tolerable than nasogastric feeding in the initial feeding of premature infants