Early full enteral feeding for preterm or low birth weight infants

Abstract

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows:We aim to assess the benefits and harms of early full enteral nutrition versus progressive introduction of enteral feeds in preterm or low birth weight (LBW) infants.Where data are available, we will undertake subgroup analyses of very preterm or very low birth weight (VLBW) infants (versus infants born a er a longer gestation or with higher birth weight), infants who are 'small for gestational age' at birth (versus those deemed 'appropriate for gestation'), infants fed with human milk only (versus formula-fed infants), and trials set in low-or middle-income countries (versus high-income countries). Early full enteral feeding for preterm or low birth weight infants (Protocol)

Nutrição enteral precoce em neonatos prematuros e com baixo peso: uma revisão integrativa

“…Embora a maioria dos estudos aponte a nutrição enteral precoce e agressiva como benéfi ca para prematuros e neonatos de baixo peso, alguns estudos contrariam essas informações, colocando em dúvida ou negando os bene cios desse po de terapia nutricional. Segundo Ohnishi et al (2016) e Walsh et al (2020), essa terapia nutricional precoce e mais agressiva precisa ser mais bem inves gada por novos estudos. Ohnishi et al (2016) afi rmam que os resultados precisam ser confi rmados por um estudo randomizado e mul cêntrico, enquanto Walsh et al (2020) afi rmam que os dados dos estudos não são sufi cientes para determinar o quão cedo a alimentação enteral completa, em comparação com a retardada, afeta o crescimento e o desenvolvimento em prematuros ou bebês com baixo peso ao nascer.…”

Advancement of Enteral Feeding in Very-low-birth-weight Infants: Global Issues and Challenges

“…87 A meta-analysis published in 2020 summarized existing randomized trials comparing ETEF to early, rapid feeding progression. 7 Six randomized trials were eligible for inclusion, with a total of 526 VLBW infants. None of the trials were masked and all were conducted in India with maternal milk used preferentially.…”

“…3 Recent randomized clinical trials (RCTs) evaluating enteral feeding initiation and/or advancements have demonstrated benefits such as reduction in the use of parenteral nutrition, the need for central venous access, and the risk of invasive infections, all without any increase in risk of SIP or NEC. [4][5][6][7][8] Following the clear and significant benefits inferred from early use of human milk for VLBW infants, 9 the practice of providing trophic feeding has been largely accepted. However, practices regarding the ideal time for initiation of enteral feeding, the duration and volume of initial feedings, and the rate of progression of feeding volumes to establish full enteral feeding among VLBW infants are widely variable.…”

Availability of donor milk improves enteral feeding but has limited effect on body growth of infants with very‐low birthweight: Data from a historic cohort study

“…For infants born with very‐low birthweight (VLBW < 1500 g), accounting for 15% of all preterm births (Corpeleijn et al, 2016), it is pivotal to acquire sufficient nutrients and energy via the enteral route in a timely fashion while avoiding feeding‐associated adverse sequelae (Dutta et al, 2015). The preferred progression of enteral feeding (EF), as early initiation of enteral nutrition (Walsh et al, 2020), fast EF advancement, and early attainment of full EF, is associated with better developmental outcomes, such as early regaining of birthweight and better neurological outcomes in the short and long term, without an increase in the incidence of feeding intolerance, necrotising enterocolitis (NEC) or sepsis (Maas et al, 2013; Walsh et al, 2020). However, there is substantial variation in the practice regarding optimal enteral feeding strategies for VLBW preterm infants, in various clinics.…”