Outcomes Related to a Standardized Feeding Approach for Low Birth Weight Infants

Abstract

A standardized approach to feeding offers numerous beneficial outcomes for low birth weight infants. Statistically significant outcomes for a decreased incidence of necrotizing enterocolitis (NEC) have been replicated across multiple studies. Studies with primary outcome measures of nutrition have found statistically significant improvements in days of parenteral nutrition, energy and protein intake from parenteral and enteral nutrition, days nil per os after feeds had been started, and days to achieve full enteral caloric feeds. Extremely low birth weight infants achieved 120 and 160 mL/kg per day significantly faster and with a significantly decreased incidence of NEC compared with controls. Additional studies with primary outcome measures of growth have found significantly lower days to return to birth weight, and significantly fewer infants discharged with weight <10th percentile. For infants born ≤29 weeks postmenstrual age, use of a standard approach to feeding resulted in significantly larger weights at 39 weeks postmenstrual age. Feeding protocols and structured evaluations of feeding tolerance decrease the variability of feeding practices within a neonatal intensive care unit. Individual feeding practices formed by experience and a fear of NEC can and should be replaced by consistency of feeding practices formed by evidence-based medicine, which may actually decrease the incidence of NEC.