Early full enteral feeding for preterm or low birth weight infants

Walsh, Verena; Brown, Jennifer Valeska Elli; Copperthwaite, Bethany R; Oddie, Sam; McGuire, William

doi:10.1002/14651858.cd013542

Cited by 19 publications

(22 citation statements)

References 48 publications

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“…The prevalence rate of EUGR, including body weight and head circumference increases as GA decreases [ 31 ]. A considerable number of studies have focused on the relationship between detailed nutritional intakes, such as early feeding, higher volume of feeding, protein intakes, milk fortification, caloric intakes and postnatal growth outcomes in preterm infants [ 3 , 9 , 10 , 32 ]. However, very few studies have examined the association of the adverse feeding trajectories with EUGR outcomes in a GA-related manner.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have demonstrated the importance of adequate feeding, nutrition and growth, especially in this preterm population [ 1 , 2 ]. Early-life feeding problems may be associated with adverse growth and neurodevelopmental outcomes [ 1 , 2 , 3 ]. Nutritional support through enteral feeding for postnatal growth in extremely preterm infants remains a challenge in clinical practice [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Growth velocities of 14–20 g/kg/day using volumes of approximately 120–150 mL/kg/day of fortified human milk or preterm formula have been recommended to provide adequate growth rates [ 3 , 6 , 7 ]. However, the introduction and advancement of enteral feeding, especially in extremely preterm infants, is often delayed or interrupted because of prematurity-related risks, exposures, and gastrointestinal (GI) morbidities [ 8 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Many studies have focused on the relationship between early feeding, protein and caloric intake and postnatal growth outcome in preterm infants [ 2 , 3 , 8 , 9 , 12 ]. The amount, composition and sources of nutrition support—such as essential fatty acids, docosahexaenoic acid and growth promoters—provided to preterm infants is important for normal growth and development; it may also influence the development of an immature gastrointestinal tract [ 15 , 16 , 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

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Gestational Age-Related Associations between Early-Life Feeding Trajectories and Growth Outcomes at Term Equivalent Age in Very Preterm Infants

et al. 2022

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Establishing the different feeding trajectories based on daily enteral feeding data in preterm infants at different gestational ages (GAs), may help to identify the risks and extrauterine growth restriction (EUGR) outcomes associated with the adverse feeding pattern. In a single center, we retrospectively included 625 infants born at 23–30 weeks of gestation who survived to term-equivalent age (TEA) from 2009 to 2020. The infants were designated into three GA groups: 23–26, 27–28, and 29–30 weeks. The daily enteral feeding amounts in the first 56 postnatal days were analyzed to determine the feeding trajectories. The primary outcomes were EUGR in body weight and head circumference calculated, respectively, by the changes between birth and TEA. Clustering analysis identified two feeding trajectories, namely the improving and adverse patterns in each GA group. The adverse feeding pattern that occurred in 49%, 20%, and 17% of GA 23–26, 27–28, and 29–30 weeks, respectively, was differentiated from the improving feeding pattern as early as day 7 in infants at GA 23–26 and 27–28 weeks, in contrast to day 21 in infants at GA 29–30 weeks. The adverse feeding patterns were associated with sepsis, respiratory, and gastrointestinal morbidities at GA 23–26 weeks; sepsis, hemodynamic and gastrointestinal morbidities at GA 27–28 weeks; and preeclampsia, respiratory, and gastrointestinal morbidities at GA 29–30 weeks. Using the improving feeding group as a reference, the adverse feeding group showed significantly higher adjusted odds ratios of EUGR in body weight and head circumference in infants at GA 23–26 and 27–28 weeks. Identifying the early-life adverse feeding trajectories may help recognize the related EUGR outcomes of preterm infants in a GA-related manner.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Gestational Age-Related Associations between Early-Life Feeding Trajectories and Growth Outcomes at Term Equivalent Age in Very Preterm Infants

et al. 2022

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“…"full milk" feeds from the day of birth. A Cochrane review on early full enteral feeding in preterm infants included 6 randomised controlled trials involving 601 stable infants weighing between 1000-1500g at birth (5). A meta-analysis of length of hospital stay (4 studies, 398 infants) showed a mean difference of -2.26 days in infants given early full enteral feeds.…”

Section: Introductionmentioning

confidence: 99%

The FEED1 Trial: Protocol for a Randomised Controlled Trial of Full Milk Feeds Versus Intravenous Fluids with Gradual Feeding for Preterm Infants (30-33 Weeks Gestational Age)

Mitchell

Meakin

Anderson

et al. 2021

Preprint

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BackgroundIn the UK, approximately 8% of live births are preterm (before 37 weeks gestation), more than 90% of whom are born between 30 and 36 weeks, forming the largest proportion of a neonatal units’ workload. Neonatologists are cautious in initiating full milk feeds for preterm infants due to fears of necrotising enterocolitis (NEC). There is now evidence to dispute this fear. Small studies have shown that feeding preterm infants full milk feeds enterally from birth could result in a shorter length of hospital stay, which is important to parents, clinicians and NHS services without increasing the risk of NEC. This trial aims to investigate whether full milk feeds initiated in the first 24 hours after birth reduces the length of hospital stay in comparison to introduction of gradual milk feeding with IV fluids.MethodsFEED1 is a multi-centre, open, parallel group, randomised, controlled superiority trial of full milk feeds initiated on the day of birth versus gradual milk feeds for infants born at 30+0 to 32+6 (inclusive) weeks gestation. Recruitment will take place in around 40 UK neonatal units. Mothers will be randomised 1:1 to full milk feeds, starting at 60 ml/kg day, or gradual feeds, as per usual local practice. Mother’s expressed breast milk will always be the first choice of milk, though will likely be supplemented with formula or donor breast milk in the first few days. Feeding data will be collected until full milk feeds are achieved (>140 ml/kg/day for 3 consecutive days). The primary outcome is length of infant hospital stay. Additional data will be collected 6 weeks post-discharge. Follow-up at 2 years (corrected gestational age) is planned. The sample size is 2088 infants to detect a between group difference in length of stay of two days. Accounting for multiple births, this requires 1700 women to be recruited. Primary analysis will compare the length of hospital stay between groups, adjusting for minimisation variables and accounting for multiple births.DiscussionThis trial will provide high-quality evidence on feeding practices for preterm infants. Full milk feeds from day of birth could result in infants being discharged sooner.Trial RegistrationISRCTN, ISRCTN89654042 prospectively registered on 23 September 2019; http://www.isrctn.com/ISRCTN89654042

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Early full enteral feeding for preterm or low birth weight infants

Walsh

Brown

Copperthwaite

et al. 2020

Cochrane Database of Systematic Reviews

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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)

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Early full enteral feeding for preterm or low birth weight infants

Cited by 19 publications

References 48 publications

Gestational Age-Related Associations between Early-Life Feeding Trajectories and Growth Outcomes at Term Equivalent Age in Very Preterm Infants

Gestational Age-Related Associations between Early-Life Feeding Trajectories and Growth Outcomes at Term Equivalent Age in Very Preterm Infants

The FEED1 Trial: Protocol for a Randomised Controlled Trial of Full Milk Feeds Versus Intravenous Fluids with Gradual Feeding for Preterm Infants (30-33 Weeks Gestational Age)

Early full enteral feeding for preterm or low birth weight infants

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