Determinants of time to full enteral feeding achievement among infants with birth weight 1000-2000g admitted to the neonatal intensive care unit of public hospitals in Hawassa city, Sidama region Ethiopian, 2019: A retrospective cohort study

Abstract

Background Nutritional care during the neonatal period is a cornerstone towards achieving optimal care. However, very limited data is available on optimizing parenteral and enteral nutrition that directly affects infant survival among Ethiopian neonates. Therefore, the objective of this study is to identify determinants of time to full enteral feeding achievement among low-birth-weight neonates admitted to neonatal intensive care units of public hospitals in Hawassa city. Methods A facility-based retrospective cohort study was conducted in Adare general hospital and Hawassa University’s comprehensive specialized hospital from August 2018 to 2019. Charts of infants with a birth weight of 1000-2000g (n = 273) neonates who were admitted to the neonatal intensive care unit (ICU) were reviewed. The sample size for each hospital was allocated proportionally and subjects were selected by using a simple random sampling technique. Data were entered using Epi. data version 3.1, and analysis was performed using SPSS version 20. Kaplan-Meier estimator and a Cox proportional hazard model were used. Result The mean (SD) age when an enteral feed (trophic feeding) was first commenced was 2.13(1.373) days. The median time to achieve full enteral feeding was 8 days with IQR (7–10 days). Gestational age reduces the time to full enteral feeding by 18.8% for each additional week of gestation (AHR = 0.812, p-value = 0.003). The time to achieve full enteral feeding was shorter by 70.4% among neonates who were small for gestational age, as compared with that appropriate for gestational age (AHR = 0.296, p-value<0.001). Conclusion According to this study, the time that the neonate takes to achieve full enteral feeding was relatively short. Gestational age and weight for gestational were the determinants for time to full enteral feeding achievement. Further research needs to be conducted to explore further, in addition to current findings.

Time to full enteral feeding and its predictors among very low birth weight (VLBW) neonates admitted to the neonatal intensive care units (NICU) in comprehensive specialized hospitals in Northwest Ethiopia

“…This study found that the median time to full enteral feeding was 10 (95% CI: 10–11) days. This finding is higher than the studies conducted in Hawassa (8 days) [ 14 ], Addis Ababa (5 days) [ 15 ], Nigeria and Kenya (8 days) [ 17 ], the UK (8 days), and India (7 days). However, it is lower than the studies done in Italy [ 19 ] and the Netherlands [ 16 ], which found that the median survival time of full enteral feeding was 13 and 20 days, respectively.…”

“…The finding is supported by studies done in India [ 25 ], Indonesia [ 26 ], and Italy [ 19 ] which revealed a higher gestational age was associated with an earlier achievement of full enteral feeding. The study conducted in Hawassa, Ethiopia, also supported this finding, which revealed that as GA increases in a week, the time to achieve full enteral feeding decreases by 18.8% [ 14 ]. This might be due to differences in physiological maturity among these groups of neonates, in whom feeding intolerance is less common while gestational age increases due to the well-developed and matured gastrointestinal system they have [ 16 ].…”

“…P = 63.4% (Proportion of neonates achieve a full enteral feeding at 14 days according to the study conducted in Hawassa [ 14 ]).…”

“…The English version of the data extraction checklist was developed from the different literatures [ 14 , 16 – 18 ]. The data were extracted from the charts of the neonates and the NICU registration logbook using a data extraction tool for the occurrence of the outcome.…”

“…Although many efforts have been made to address the poor practice of early initiation of enteral nutrition among neonates in Ethiopia [ 14 ], a considerable number of neonates were kept NPO in the first days after birth [ 15 ].…”