Slow versus rapid enteral feeding advancement in preterm newborn infants 1000–1499 g: a randomized controlled trial

Krishnamurthy, Sriram; Gupta, Piyush; Debnath, Sanjib; Gomber, Sunil

doi:10.1111/j.1651-2227.2009.01519.x

Cited by 92 publications

(95 citation statements)

References 21 publications

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“…Our study's results were comparable with other studies worldwideKaragol et al [19], Krishnamurthy et al [18] and Caple et al [20].…”

supporting

confidence: 93%

“…There was reduction in duration of hospital stay as well as less duration of parenteral nutrition in rapid feeding group. In current study full feeds were reached at an earlier age in both slow and rapid feeding groups as compared to study by Vasu et al, and Krishnamurthy et al [17,18]. We also found that rapid feeding group does not have increased incidence of mortality or sepsis compared to slow feeding group.…”

supporting

confidence: 69%

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

Kadam¹,

Prasad²,

Santosh³

2014

J Neonatal Biol

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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 enteral feeding regimen (increments of 25-30 ml⁄ kg ⁄day) in stable preterm neonates less than 34 weeks of gestation.

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“…Our study's results were comparable with other studies worldwideKaragol et al [19], Krishnamurthy et al [18] and Caple et al [20].…”

supporting

confidence: 93%

supporting

confidence: 69%

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

Kadam¹,

Prasad²,

Santosh³

2014

J Neonatal Biol

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“…Despite encouraging results supporting more rapid enteral feeding (EF) advancement in very low birth weight infants (VLBWIs) [1,2,3,4], there is still remarkable variability in EF practices [5], which are still rather cautious [6] and dominated by fear of necrotizing enterocolitis (NEC) [7,8,9]. …”

Section: Introductionmentioning

confidence: 99%

A Historic Cohort Study on Accelerated Advancement of Enteral Feeding Volumes in Very Premature Infants

Maas

Mitt²,

Full³

et al. 2012

Neonatology

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Background: The optimal rate of enteral feeding (EF) advancement in very low birth weight infants is under debate. Objectives: To evaluate the effects of accelerated EF advancement on the time to full enteral feeds, on early postnatal growth as well as on the frequency of necrotizing enterocolitis (NEC) and focal intestinal perforation (FIP) in very premature infants. Methods: In a retrospective single-center historic cohort study, infants with a gestational age <32 weeks at birth and birth weight <1,500 g, born between January 1, 2006, and December 31, 2007 (n = 136), were compared with infants born between January 1, 2010, and December 31, 2010 (n = 88). In 2006/2007, enteral feeds were initiated on day 1 with 10–15 ml/kg/day and advanced by 15–20 ml/kg/day. In 2010, enteral feeds were initiated with 20 ml/kg/day on day 1 and advanced by 25–30 ml/kg/day. Full enteral feeds were defined as ≥140 ml/kg/day. Data are presented as median (P25–P75). Results: The time to establish full enteral feeds was shorter in 2010: 8 (7–11) days in 2006/2007 versus 6 (5–9) days in 2010. The incidences of NEC and FIP were 2.7 and 4.1% in 2006/2007 and 3.3 and 2.2% in 2010, respectively. Weight gain was not affected by the rate of EF advancement. Higher parenteral protein intake during week 1 in 2006/2007 was associated with better head circumference growth. Conclusions: The new approach was associated with a significantly shorter period to establish full enteral feeds. No difference in the incidence of FIP or NEC was observed; however, the study was underpowered to detect small but possibly important differences.

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“…While the median time interval until on full feeds in the study by Maas et al [1] seems very short for the accelerated enteral feeding regimen, a direct comparison with previous reports is difficult since no systematic analysis and data on this time interval have been published so far [3]. However, some reports have demonstrated that neonates with rapid feeding advancement (30 ml/kg/day) achieve full volume feedings before the slow advancement group (median 7 vs. 9 days) (p < 0.001), have significantly fewer days of intravenous fluids (median 2 vs. 3.4 days) (p < 0.001), shorter length of stay in hospital (median 9.5 vs. 11 days) (p = 0.003) and regain birth weight earlier (median 16 vs. 22 days) (p < 0.001) while no statistical differences in the proportion of infants with apnoea, feed interruption or feed intolerance were noted [4]. Of note, the authors of this report excluded extremely low birth weight infants ‘since babies less than 1,000 g are often sick, have a higher mortality and may not be appropriate candidates for rapid feeding protocols’ [4].…”

mentioning

confidence: 99%

Feeding Regimens and Necrotising Enterocolitis

Meyer

Butte

2013

Neonatology

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Slow versus rapid enteral feeding advancement in preterm newborn infants 1000–1499 g: a randomized controlled trial

Abstract: Rapid enteral feeding advancements of 30 mL/kg/day are well tolerated by stable preterm neonates weighing 1000-1499 g.

Cited by 92 publications

References 21 publications

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

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

A Historic Cohort Study on Accelerated Advancement of Enteral Feeding Volumes in Very Premature Infants

Feeding Regimens and Necrotising Enterocolitis

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