Safety of initiating early enteral feeding with slow volume advancement in preterm infants
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Updated: Jun 7, 2026

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Published on: April 19, 2024
Kriangsak Jirapaet1, Veena Jirapaet, Suthida Sritipsukho
1Department of Pediatrics, Faculty ofMedicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. sikjr@mahidol.ac.th
Objective:
To determine the safety of enteral feeding within 24 hours of life with slow volume increase on the incidence of necrotizing enterocolitis (NEC) and late-onset sepsis (LOS).
Design:
Prospective descriptive study.
Material And Method:
Between January 1998 and December 2001, 117 preterm infants with birth weight < or =1750 g were recruited prospectively, 102 in the human-milk-fed group (HMG) and 15 in the formula-fed group (FG). Feeds were advanced by increments of 10 mL/kg/d, aimed at 150 mL/kg/d in 15 days. Charts of 146 preterm infants admitted during 1996-1997 were reviewed for pre-study incidences of NEC and LOS.
Results:
NEC developed 3.92% in HMG and 20% in FG (p =.044). LOS developed 2.94% in HMG and 13.33% in FG (p = 0.122). The overall incidence of NEC was almost similar (5.98% vs. 6.16%) while that of LOS was lower (4.27% vs. 12.32%) when compared to the pre-study incidences.
Conclusion:
The present study provides a practice that seems to reduce LOS risk without increasing NEC risk and confirms the protective effect of human milk against NEC.
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