COMPARING OUTCOMES OF DIFFERENT FEEDING VOLUMES IN PRETERM INFANTS

Optimal entral feeding methods in preterm infants have not been well defined.
Controversy exists regarding when feedings should be started, whether minimal entral feedings should
be used routinely in small preterm infants, and how fast to advance entral feedings. Preterm infants
can exhibit delayed gastric emptying and often have feeding residuals. So, entral feedings are
frequently advanced slowly in these neonates. However, recent data challenged this idea. The goal of
this study was to compare outcomes of different feeding volumes advancing in preterm infants.
Methods & Materials: In this controlled randomized clinical trial, 140 preterm infants with gestation
age 30-34 weeks were enrolled in Tabriz Alzahra Teaching Hospital in a 12-month period of time.
They randomized in three groups; feeding of milk advanced at 20ml/kg/day (group one, 60 neonates),
feeding of milk advanced at 24ml/kg/day (group two, 40 neonates), and feeding of milk advanced at
30ml/kg/day (group three, 40 neonates). Outcomes were compared between the three groups.
Results: Weight gain was not significantly different between the three groups in a 7-day period. Age
of commencement of oral intake, time to achieve the milk volume of 150ml/kg, duration of
intravenous fluid therapy, duration of antibiotic therapy, total hospital stay, time to achieve the birth
weight, NPO duration, full entral feeding time, duration of oxygen need and duration of mechanical
ventilation were all significantly better in the third group comparing with the first one. This condition
was present for the second group comparing with the first group except for the age of commencement
of oral intake and NPO duration. The condition was better in the third group comparing with the
second group regarding the time to achieve the milk volume of 150ml/kg and full entral feeding time.
The complications were minimal in all neonates.
Conclusion: Increase of entral feeding at a rate of 30ml/kg/day is safe and superior to 20ml/kg/day
and 24ml/kg/day in preterm infants. It is necessary future studies with large number of patients before
recommendation of this increase rate for entral feeing.