Enteral feeding in infants <1250 g starting within 24 h post-partum

Abstract.

Establishing enteral feeding in the very low birth weight infant as soon as possible after birth has been shown to promote growth and reduce the need for intravenous lines. Human milk can be administered either as a continuous infusion or as intermittent boluses. The aim of this study was to investigate the effect of continuous versus bolus feeding on gastrointestinal tolerance, time to reach 120 ml/kg, 150 ml/kg and full enteral feeding, regain birth weight, duration of intravenous lines, incidence of septicaemia, persistent ductus arteriosus and necrotising enterocolitis. A retrospective analysis of hospital records was performed. Infants with a birth weight <1250 g born during a 12-month period at Aker and Ullevål University hospitals in Oslo, who survived the first 21 days, were included in the study. A Total of 49 infants (25 continuous and 24 bolus) fulfilled the entry criteria and data from these infants were analysed. Enteral feeding volumes (120ml/kg, 150 ml/kg and full) were attained significantly faster with continuous feeding (7 versus 12 days, 8 versus 14 days, 9 versus 12 days). Consequently the bolus group had a significantly longer duration of intravenous lines (14 versus 9 days). There were no differences regarding time to regain birth weight, the incidence of septicaemia, persistent ductus arteriosus or necrotising enterocolitis. Conclusion: infants of birth weight <1250 g can be fed breast milk already from the 1st day of life and achieve full enteral feeds faster than previously reported even in more mature infants. Full enteral feeds are attained faster with continuous versus bolus feedings and continuous feeding therefore results in shorter need for intravenous fluids.