Related Experiment Videos
Effect of intermittent versus continuous enteral feeding on energy expenditure in premature infants
1Department of Pediatrics, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis 46202-5210.
Insights
Premature infants show higher energy expenditure with intermittent feeding compared to continuous feeding. Continuous feeding appears more energy-efficient, similar to adults, but clinical significance requires further study.
Area of Science:
- Neonatal Nutrition
- Metabolic Studies
- Pediatric Gastroenterology
Background:
- Premature infants have unique metabolic needs.
- Understanding energy expenditure is crucial for infant growth and development.
- Diet-induced thermogenesis (DIT) plays a role in energy balance.
Purpose of the Study:
- To compare energy expenditure and DIT in premature infants between intermittent and continuous feeding methods.
- To determine if feeding method impacts metabolic rate in neonates.
Main Methods:
- Open-circuit respiratory calorimetry was used to measure energy expenditure in 11 premature infants.
- Infants were studied over two days, receiving the same formula amount via intermittent bolus or continuous drip feeding.
- Diet-induced thermogenesis was assessed during and after feeding periods.
Main Results:
- Intermittent feeding resulted in a 15% peak increase in DIT, while continuous feeding showed no significant DIT response.
- Overall energy expenditure was significantly higher with intermittent feeding (2.18 kcal/kg/hr) versus continuous feeding (2.09 kcal/kg/hr).
- A mean difference of 4% (up to 17%) in energy expenditure was observed between the two feeding modes.
Conclusions:
- Continuous feeding in premature infants is more energy-efficient than intermittent feeding.
- Findings align with observations in adult metabolic studies.
- Further research is needed to ascertain the clinical significance of energy efficiency gains from continuous feeding in neonates.
Abstract:
The purpose of this study was to examine whether premature infants have higher rates of energy expenditure and diet-induced thermogenesis during intermittent feeding compared with continuous feeding. Using open-circuit respiratory calorimetry, we measured energy expenditure in 11 premature newborn infants on 2 successive days for 5 to 7 hours during and after either intermittent or continuous feeding. Infants were fed the same quantity of formula each day, either for 5 minutes or by continuous drip for 2 to 3 hours. The order of feeding type was randomized. No response of diet-induced thermogenesis to continuous feeding was found, whereas a peak increase of 15% over baseline was observed after intermittent feeding. Overall energy expenditure during the study period was significantly greater after intermittent compared with continuous feeding (2.18 +/- 0.07 kcal/kg per hour vs 2.09 +/- 0.05 kcal/kg per hour; p less than 0.05). Thus there was a mean 4% difference (range up to 17%) in energy expenditure between the two feeding modes. These results are similar to those obtained with adults and support the concept of the increased energy efficiency of continuous feeding. Further study will be necessary to document whether the increased energy efficiency provided by continuous feeding may be clinically significant.