Growth and morbidity of extremely preterm infants after early full enteral nutrition

Arch Dis Child Fetal Neonatal Ed. 2018 Jan;103(1):F79-F81. doi: 10.1136/archdischild-2017-312917. Epub 2017 Jul 21.

Abstract

Objectives: To evaluate feasibility and consequences of accelerated feeding advancement on short-term outcomes in extremely low gestational age neonates (ELGANs) who stayed in our institution for >28 days.

Methods: Retrospective single-centre cohort analysis covering the years 2011-2013. Data are presented as median (IQR).

Results: Infants '(n=77) birth weight was 745 (640 to 960) g and gestational age at birth 26.7 (25.1 to 27.4) weeks. Full enteral feeds were attained by postnatal day 7 (5 to 11). Weight gain from birth to discharge was 14.3 (13.3 to 16.1) g/kg/day, change in SD score for weight -0.03 (-0.55 to 0.46) and 0.09 (-0.78 and 0.82) for head circumference. Rates of necrotising enterocolitis and spontaneous intestinal perforation in all ELGANs admitted during the study period were 3.1% and 9.4%, respectively.

Conclusions: This cohort of ELGANs showed good weight gain and head growth after early full enteral nutrition. The impact of this feeding practice on neonatal morbidity and long-term outcome remains to be tested in adequately powered randomised trials.

Keywords: Nutrition; extremely low birth weight infants; feeding methods; infant, newborn; infant, premature; necrotizing enterocolitis; weight gain.

MeSH terms

  • Enteral Nutrition* / adverse effects
  • Enteral Nutrition* / methods
  • Enteral Nutrition* / statistics & numerical data
  • Enterocolitis, Necrotizing* / etiology
  • Enterocolitis, Necrotizing* / prevention & control
  • Female
  • Germany / epidemiology
  • Gestational Age
  • Humans
  • Infant, Extremely Premature / growth & development
  • Infant, Newborn
  • Infant, Premature, Diseases / epidemiology
  • Infant, Premature, Diseases / therapy*
  • Infant, Very Low Birth Weight / growth & development
  • Intestinal Perforation* / etiology
  • Intestinal Perforation* / prevention & control
  • Male
  • Outcome and Process Assessment, Health Care
  • Patient Discharge / statistics & numerical data
  • Retrospective Studies
  • Time-to-Treatment
  • Weight Gain