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Does the enteral feeding advancement affect short-term outcomes in very low birth weight infants?

Christoph Härtel1, Berit Haase, Kathryn Browning-Carmo

  • 1Department of Pediatrics, University of Lübeck, Germany.

Journal of Pediatric Gastroenterology and Nutrition
|March 27, 2009
PubMed

Insights

Advancing enteral feeding rapidly in very low birth weight infants (VLBW) was linked to lower sepsis rates. Slow advancement of feeding in VLBW infants correlated with increased sepsis and more central venous line and antibiotic use.

Area of Science:

  • Neonatal intensive care
  • Pediatric nutrition
  • Clinical outcomes research

Background:

  • Optimal enteral feeding strategies for very low birth weight (VLBW) infants remain debated.
  • Rapid feeding advancement may increase necrotizing enterocolitis risk, while delayed feeding can impair growth and neurodevelopment.

Purpose of the Study:

  • To compare short-term outcomes of VLBW infants based on center-specific enteral feeding advancement rates.

Main Methods:

  • A prospective study of 1430 VLBW infants across 13 German tertiary neonatal intensive care units.
  • Centers were categorized into rapid advancement (RA; <=12.5 days) and slow advancement (SA; >12.5 days) groups post hoc.

Main Results:

  • Infants in SA centers (n=713) had significantly higher sepsis rates than those in RA centers (n=717), particularly late-onset sepsis (20.4% vs 14.0%).
  • SA centers used more central venous lines (48.6% vs 31.1%) and antibiotics (92.4% vs 77.7%).

Conclusions:

  • Center variations in enteral feeding advancement impact short-term outcomes like nosocomial sepsis in VLBW infants.
  • Further large, multicenter trials are needed to determine the optimal feeding strategy for VLBW infants.
Abstract

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