Rapid Versus Slow Advancement of Feeds in Preterm Babies Less than 34 Weeks in Incidence of NEC and Feed Intolerance

Rahul Mansing Kadam,Vsv Prasad

doi:10.4172/2167-0897.1000214

Abstract

Objective: To evaluate whether preterm neonates less than 34 weeks at birth receiving rapid enteral feeding advancement at 25-30 ml/kg/day and those receiving slow enteral feeding advancement at 15-20 mL⁄kg⁄day to attain full feeding (180 ml/kg/day) are atincrease in the incidence of necrotizing enterocolitis or feed intolerance. Study design: Retrospective cohort study. Setting: Level III Neonatal Unit in Southern India Subjects: Neonates born at <34 weeks of gestational age and admitted to the NICU during study period were enrolled. Outcome: Mortality and major morbidity - NEC as per Bell staging, incidence of feedintolerance. Results: Both groups had similar baseline characteristics. The average gain in weight, length and head circumference were significantly lower in the slow feeding group as compared rapid feeding group. The mean days to reach birth weight was less in rapid feeding group; 12.43 vs. 15.46 in slow feeding group (p=0.04). It was inferred that duration of hospital stay (22.58 vs. 31.34 days) and parenteral nutrition( 8.69 vs. 11.18 days) was less in rapid feeding group as compared to slow feeding group (p= 0.04). Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation Rapid feeding group does not have increased episodes of feed intolerance or NEC (5 vs. 6 cases) compared to slow feeding group. Conclusions: Our study support enteral nutrition by rapid enter

Highlights

The delivery of a preterm baby is a nutritional emergency
Our study support enteral nutrition by rapid enteral feeding regimen in stable preterm neonates less than 34 weeks of gestation
Inspite of extensive research in nutrition of very low birth weight preterm infants, still there are lot of controversies as to what is the nutritional goal, what should be the composition of postnatal feeds to match the intrauterine growth and methods to provide optimal nutrition to improve both short term and long term outcomes in very low birth weight infants

Summary

Introduction

The delivery of a preterm baby is a nutritional emergency. After stabilization of initial problems including respiratory status, nutrition is the major challenge in front of the treating neonatologist. The appropriate goals of low birth weight feed includes ensuring adequate short term growth, preventing feeding related morbidities, optimizing long term outcomes including its impact on adult onset diseases (e.g. coronary artery disease, diabetes mellitus, etc.). Over last 2 decades the concept of minimal enteral nutrition has evolved which is defined as starting small amount of enteral feeding (exact volume not defined) usually 5-25 ml/kg as soon as possible after birth. This has numerous positive impacts on development and maturation of gut function, hormonal and digestive enzyme surge [2,3]. There are numerous studies, which have shown the beneficial effects of MEN none of these studies have demonstrated any increase in the incidence of NEC larger trials are required regarding safety in very immature and critically sick babies [4,5]

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Results

Conclusion