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Feeding intolerance in the preterm infant

Silvia Fanaro1

  • 1Neonatal Intensive Care Unit, Paediatric Section, University of Ferrara, Italy.

Early Human Development
|August 22, 2013
PubMed

Insights

Feeding intolerance (FI) in preterm infants, often due to immature gut function, can mimic serious conditions. This review covers its aspects, prevention, and treatment strategies.

Area of Science:

  • Neonatalogy
  • Gastroenterology
  • Pediatric Nutrition

Background:

  • Feeding intolerance (FI) is common in very preterm infants, characterized by difficulty digesting enteral feedings.
  • FI symptoms like increased gastric residuals, abdominal distension, and emesis can overlap with necrotizing enterocolitis, complicating management.
  • Suboptimal nutrition and delayed feeding can result from inconsistent FI interpretation.

Purpose of the Study:

  • To review the pathophysiology, clinical presentation, and management of feeding intolerance in very preterm infants.
  • To summarize evidence-based prevention and treatment strategies for feeding intolerance.
  • To address practical considerations in managing feeding intolerance in this vulnerable population.

Main Methods:

  • Literature review of studies on feeding intolerance in very preterm infants.
  • Synthesis of information on pathophysiology, clinical signs, and diagnostic challenges.
  • Analysis of prevention and treatment strategies from clinical trials and systematic reviews.

Main Results:

  • Feeding intolerance is frequently observed in very preterm infants, often linked to gastrointestinal immaturity.
  • Differentiating FI from necrotizing enterocolitis is challenging due to overlapping symptoms.
  • Limited large-scale, validated strategies exist for FI prevention and treatment.

Conclusions:

  • Consistent interpretation of FI signs is crucial for optimal nutritional management in preterm infants.
  • Further research and validated interventions are needed to effectively prevent and treat feeding intolerance.
  • Addressing practical issues in FI management is essential for improving outcomes.

Keywords:
Enteral feedingFeeding intoleranceGastric residualPreterm

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