Impact of Feeding Interval on Time to Achieve Full Oral Feeding in Preterm Infants: A Randomized Trial

Abstract

Background Preterm infants are scheduled to receive total feeding amount in either 3‐hour or 2‐hour intervals. A gavage feeding may be required if the scheduled amount is not completed orally. Feedings every 2 hours are one‐third smaller than feedings every 3 hours. Thus, if the volume of each feed is reduced by decreasing the feeding interval from 3 to 2 hours, the likelihood that the infant completes each volume orally increases, and the probability of requiring gavage feeding decreases. The impact of feeding with 2‐hour or 3‐hour intervals on time to achieve full oral feeding in preterm infants was investigated. Methods Infants on full enteral gavage feedings were randomized into 2 groups to receive feedings in either 3‐hour or 2‐hour intervals. The time to achieve full oral feeding and the duration of feeding transition from gavage to oral feedings were investigated. Data were presented as median (interquartile range). Results The study included 100 infants (gestational age: 29 [28–31] weeks, birth weight: 1205 [1040–1380] g) with 50 in each group. The postmenstrual age to achieve full oral feeding was 35 (35–37) weeks in the 3‐hour‐interval group and 35 (34–36) weeks in the 2‐hour‐interval group; P = 0.131. The duration of feeding transition was similar between groups. Conclusions Feeding every 2 hours caused no improvement in the time to achieve full oral feeding. The 3‐hour‐interval feeding is appropriate for the neonatal units, where less handling of preterms and decreased workload of nurses are valuable.

Three-Hourly versus Two-Hourly Feeding Interval in Stable Preterm Infants: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…We screened through titles and/or abstracts of 2612 articles, of which 23 were considered potentially relevant for full-text screening. Out of 23, six reports [11,12,[20][21][22][23] ful lled the inclusion criteria and were evaluated for qualitative and quantitative synthesis (Fig. 1).…”

“…Six studies (872 participants) are included in this systematic review [8,11,12,[20][21][22]. The mean gestation varied between 30-32 weeks across the trials.…”

“…Moreover, these results were limited to achieving full gavage feeds and did not assess the impact on the further transition to oral feeds and time to discharge. Recently a few more studies comparing the two feeding schedules have been published [11,12], warranting a systematic relook into the evidence.…”

Effects of different feeding intervals on the feeding outcomes of infants who underwent surgical repair of ventricular septal defects

“…Their results showed that a 3-h feeding interval was suitable for the neonatal ward. 18 However, a literature search found that there are still few reports regarding the impact of the feeding interval on infants' feeding outcomes after cardiac surgery. This prospective study was carried out to determine the postoperative feeding interval for infants who underwent surgical repair of VSDs.…”

Safety and Parental Satisfaction With Early Discharge of Preterm Infants on Nasogastric Tube Feeding and Outpatient Clinic Follow-Up

“…In our cohort, infants of 27–31 + 6 weeks of gestation were discharged at 34.7 (34.3–36.0) weeks ( Table 3 ). In the literature some subgroups of VLBW infants achieved full enteral feeding on average at about 35 weeks ( 6 , 18 – 20 ). On average, these infants were discharged beyond 36 weeks of gestation.…”