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Ad libitum or demand/semi-demand feeding versus scheduled interval feeding for preterm infants

K Tosh, W McGuire

    The Cochrane Database of Systematic Reviews
    |July 21, 2006
    PubMed

    Insights

    Feeding preterm infants on demand may lead to slower weight gain but potentially earlier hospital discharge. More research is needed to confirm these effects on growth and discharge timing for preterm infants.

    Area of Science:

    • Neonatal care
    • Pediatric nutrition
    • Evidence-based medicine

    Background:

    • Feeding preterm infants based on hunger cues (ad libitum/demand feeding) may improve oral feeding establishment, nutrient intake, growth, and shorten hospital stays.
    • Scheduled interval feeding is a common alternative practice.

    Purpose of the Study:

    • To evaluate the impact of ad libitum/demand feeding versus scheduled feeding on preterm infants' growth rates.
    • To assess the effect of feeding policies on the time to hospital discharge for preterm infants.

    Main Methods:

    • Systematic review of randomized and quasi-randomized controlled trials.
    • Searches included Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, and conference proceedings.
    • Primary outcomes were growth rates and age at hospital discharge.

    Main Results:

    • Seven trials compared ad libitum/demand feeding with scheduled feeding in preterm infants transitioning to oral feeds.
    • Most trials were small, of variable quality, and likely underpowered to detect growth effects.
    • One trial indicated lower weight gain with ad libitum feeding; findings on earlier hospital discharge were inconsistent.

    Conclusions:

    • Insufficient data exist to guide clinical practice regarding feeding policies for preterm infants.
    • A large, well-designed randomized controlled trial is necessary to determine the effects of ad libitum/demand feeding on growth and discharge timing.
    Abstract

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