Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

The early use of minimal enteral nutrition in extremely low birth weight newborns

Abstract

Objective:

To gather information regarding the efficacy of early minimal enteral nutrition on overall feeding tolerance in extremely low birth weight infants.

Study Design:

Prospective randomized controlled trial comparing the early use of minimal enteral nutrition in extremely low birth weight infants from day 2 to day 7 vs control infants. On day 8, feeding volume in both groups were advanced by 10 ml kg−1 day−1 until full enteral feedings were reached. Time to full feeds, number of intolerance episodes, anthropometric measurements, peak total bilirubin levels, incidence of necrotizing enterocolitis and incidence of sepsis were compared between the two groups with t-test and χ2 test.

Result:

Eighty-four infants were enrolled in the study but only 61 infants completed the feeding protocol. No statistically significant differences were found between the groups with regards to growth patterns, feeding tolerance, mortality, length of hospital stay and incidence of sepsis and necrotizing enterocolitis.

Conclusion:

Early minimal enteral nutrition use in extremely low birth weight infants did not improve feeding tolerance.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Berseth CL . Effect of early feeding on maturation of the preterm infant's small intestine. J Pediatr 1992; 120: 947–953.

    Article  CAS  Google Scholar 

  2. Dunn L, Hulman S, Weiner J, Kliegman R . Beneficial effects of early hypocaloric enteral feeding on neonatal gastrointestinal function: preliminary report of a randomized trial. J Pediatr 1988; 112 (4): 622–629.

    Article  CAS  Google Scholar 

  3. Newell SJ . Enteral feeding of the micropremie. Clin Perinatol 2000; 27: 221–234.

    Article  CAS  Google Scholar 

  4. McClure RJ, Newell SJ . Randomised controlled trial of trophic feeding and gut motility. Arch Dis Child Fetal Neonatal Ed 1999; 80: F54–F58.

    Article  CAS  Google Scholar 

  5. Berseth CL, Nordyke C . Enteral nutrients promote postnatal maturation of intestinal motor activity in preterm infants. Am J Physiol 1993; 264: G1046–G1051.

    CAS  PubMed  Google Scholar 

  6. al Tawil Y, Berseth CL . Gestational and postnatal maturation of duodenal motor responses to intragastric feeding. J Pediatr 1996; 129: 374–381.

    Article  CAS  Google Scholar 

  7. Berseth CL . Gastrointestinal motility in the neonate. Clin Perinatol 1996; 23: 179–190.

    Article  CAS  Google Scholar 

  8. Slagle TA, Gross SJ . Effect of early low-volume enteral substrate on subsequent feedingtolerance in very low birth weight infants. J Pediatr 1988; 113 (3): 526–531.

    Article  CAS  Google Scholar 

  9. Ostertag SG, LaGamma EF, Reisen CE, Ferrentino FL . Early enteral feeding does not affect the incidence of necrotizing enterocolitis. Pediatrics 1986; 77 (3): 275–280.

    CAS  PubMed  Google Scholar 

  10. Davey AM, Wagner CL, Cox C, Kendig JW . Feeding premature infants while low umbilical artery catheters are in place: a prospective, randomized trial. J Pediatr 1994; 124 (5): 795–799.

    Article  CAS  Google Scholar 

  11. Meetze WH, Valentine C, McGuigan JE, Conlon M, Sacks N, Neu J . Gastrointestinal priming prior to full enteral nutrition in very low birth weight infants. J Pediatr Gastroenterol Nutr 1992; 15 (2): 163–170.

    Article  CAS  Google Scholar 

  12. Troche B, Harvey-Wilkes K, Engle WD, Nielsen HC, Frantz ID, Mitchell ML . Early minimal feedings promote growth in critically ill premature infants. Biol Neonate 1995; 67: 172–181.

    Article  CAS  Google Scholar 

  13. Schanler RJ, Shulman RJ, Lau C, Smith EO, Heitkemper MM . Feeding strategies for premature infants: randomized trial of gastrointestinal priming and tube-feeding method. Pediatrics 1999; 103 (2): 434–439.

    Article  CAS  Google Scholar 

  14. Tiffany KF, Burke BL, Collins-Odoms C, Oelberg DG . Current practice regarding the enteral feeding of high-risk newborns with umbilical catheters in situ. Pediatrics 2003; 112: 20–23.

    Article  Google Scholar 

  15. Wilson CD, Cairns P, Halliday HL, Reid M, McClure G, Dodge JA . Randomised controlled trial of an aggressive nutritional regimen in sick very low birth weight infants. Arch Dis Child 1997; 77: F4–F11.

    Article  CAS  Google Scholar 

  16. Rayyis SF, Ambalavanan N, Wright L, Waldemar AC . Randomized trial of‘slow’ versus ‘fast’ feed advancements on the incidence of necrotizing enterocolitis in very low birth weight infants. J Pediatr 1999; 134 (3): 293–297.

    Article  CAS  Google Scholar 

  17. Caple J, Armentrout D, Huseby V, Halbardier B, Garcia J, Sparks JW . Randomized, controlled trial of slow versus rapid feeding advancement in preterm infants. Pediatrics 1997; 114 (6): 1597–1600.

    Article  Google Scholar 

  18. Berseth CL, Bisquera JA, Paje VU . Prolonging small feeding volumes early in life decreases the incidence of necrotizing enterocolitis in verly low birth weight infants. Pediatrics 2003; 111 (3): 529–534.

    Article  Google Scholar 

  19. Kuzma-O'Reilly B, Duenas ML, Greecher C, Kimberlin L, Mujsce D, Miller D . Evaluation, development, and implementation of potentially better practices in neonatal intensive care nutrition. Pediatrics 2003; 111 (4): e461–e470.

    PubMed  Google Scholar 

Download references

Acknowledgements

We acknowledge Dr Richard Martin and Dr Monika Bhola for their thoughtful review of the manuscript. We thank Julie Di Fiore and Mary Ann O'Riordan for providing help with the statistical analysis. We also thank Linda Juretschke NNP, Zeynep Salih MD, and Mathew Co for their assistance in data collection and manuscript preparation.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to E Mosqueda.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mosqueda, E., Sapiegiene, L., Glynn, L. et al. The early use of minimal enteral nutrition in extremely low birth weight newborns. J Perinatol 28, 264–269 (2008). https://doi.org/10.1038/sj.jp.7211926

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jp.7211926

Keywords

This article is cited by

Search

Quick links