Related Experiment Video
Updated: May 10, 2026
Non-Nutritive Suck Parameters Measurements Using a Custom Pressure Transducer System
Published on: April 19, 2024
Very early feeding in stable small for gestational age preterm infants: a randomized clinical trial
Shmuel Arnon1, Daniella Sulam, Fred Konikoff
1Neonatal Department, Meir Medical Center, Kfar Saba, Israel. Faculty of Medicine, Sackler School of Medicine, Tel Aviv, Israel. shmuelar@clalit.org.il
Insights
Initiating very early feeding in stable, small for gestational age (SGA) preterm infants significantly shortens the time to full enteral feeding and hospital discharge. This approach did not increase the risk of necrotizing enterocolitis (NEC) or other morbidities.
Area of Science:
- Neonatal Nutrition
- Pediatric Gastroenterology
Background:
- Small for gestational age (SGA) preterm infants often experience feeding challenges.
- Optimal timing for initiating enteral feeding in stable SGA preterm infants remains a key clinical question.
Purpose of the Study:
- To evaluate the impact of very early enteral feeding initiation on the time to achieve full feeding in stable SGA preterm infants.
Main Methods:
- A randomized controlled trial comparing very early (within 24 hours) versus delayed (after 24 hours) feeding in stable SGA preterm infants with absent or reverse diastolic flow.
- Outcomes included time to full enteral feeding, feeding progression, and morbidity.
- Gastric motility was assessed using electrogastrography (EGG).
Main Results:
- Infants in the very early feeding group reached full enteral feeding significantly faster (98±80-157 hours) than controls (172±123-261 hours).
- Earlier hospital discharge was observed in the very early feeding group.
- No cases of necrotizing enterocolitis (NEC) were reported in either group.
Conclusions:
- Very early feeding initiation is safe and effective for stable SGA preterm infants.
- This feeding strategy accelerates achievement of full enteral feeds and reduces length of hospital stay without increasing morbidity.
Objective:
To examine the effect of initiating very early feeding on time-to-reach full feeding in stable, small for gestational age (SGA) preterm infants.
Method:
Preterm infants with gestational age below 37 weeks and birth weight below the 10(th) percentile were randomly allocated to a very early (within 24 hours of birth) feeding regimen or delayed (after 24 hours of birth) feeding. All infants had in utero evidence of absent or reverse diastolic flow. Infants unable to start early feeding were excluded. Time-to-reach full feeding, feeding progression, and related morbidity were compared. Electrogastrography (EGG) was used to measure pre- and postprandial gastric motility on the second and seventh day after feeding initiation.
Results:
Sixty infants were included in the study, 30 in each group. Infants included in the very early feeding regimen achieved full enteral feeding sooner than controls (98±80-157 vs. 172±123-261 hours of age, respectively; p= 0.004) and were discharged home earlier (p=0.04). No necrotizing enterocolitis (NEC) was documented in both study groups. Gastric motility was improved at day seven after feeding initiation in both study groups, with no difference between groups.
Conclusions:
Stable SGA preterm infants on a very early feeding regimen achieved full enteral feeding and were discharged home significantly earlier than those on a delayed regimen, with no excess morbidity.
