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Benefits of early enteral nutrition in extremely low birth weight infants
Aniko Manea1, Marioara Boia1, Daniela Iacob1
1Department of Neonatology, Victor Babeş University of Medicine and Pharmacy, Timişoara, Romania.
Insights
Early enteral nutrition improved weight gain in extremely low birth weight (ELBW) infants. Breast milk feeding led to better weight gain and reduced infection rates compared to formula in ELBW infants.
Area of Science:
- Neonatology
- Pediatric Nutrition
- Infant Growth and Development
Background:
- Extremely low birth weight (ELBW) infants exhibit immature organ systems, increasing vulnerability.
- Early enteral feeding is crucial for digestive tolerance and growth in preterm infants.
- Comparing formula vs. breast milk for ELBW infants is essential for optimizing outcomes.
Purpose of the Study:
- To evaluate the impact of early enteral feeding on digestive tolerance in ELBW infants.
- To compare growth rates between ELBW infants fed formula versus breast milk.
- To assess the incidence of infection and necrotizing enterocolitis (NEC) in relation to feeding type.
Main Methods:
- A cohort of 34 ELBW infants were divided into two groups: formula (Group I) and breast milk (Group II).
- Early enteral nutrition was initiated with standardized feeding protocols for both groups.
- Infants were monitored for digestive intolerance, NEC, infection, and growth parameters.
Main Results:
- Group II (breast milk) showed significantly greater weekly weight gain (120.83 g) compared to Group I (formula) (97.27 g).
- Infection incidence was 100% in the formula group versus 66.6% in the breast milk group.
- Two cases of NEC were observed in the formula-fed group.
Conclusions:
- Early enteral feeding positively influences weight gain in ELBW infants.
- Breast milk is superior to formula in promoting weight gain and reducing infection and NEC incidence in ELBW infants.
- Optimizing nutrition with breast milk is critical for improving ELBW infant outcomes.
Introduction:
Extremely low birth weight (ELBW) infants (i.e. preterm infants weighing < 1,000 g) often present with morphofunctional multiple organ immaturity. This study aimed to determine whether early enteral feeding improves digestive tolerance, and whether there is a difference in growth between ELBW infants who were fed with formula and those who were fed with breast milk.
Methods:
This study was conducted from 2012-2013 and involved 34 ELBW infants from the Preterm Neonatology Clinic of the 'Louis Turcanu' Clinical Children's Hospital Timisoara, Romania. Early enteral nutrition was introduced for all the infants - Group I was fed with formula, while Group II was fed with breast milk. Infants in each group were given their designated type of milk (formula/breast milk), using the same feeding method and the same volume rate advancement. They were monitored for any evidence of digestive intolerance (i.e. clinical signs of infection and necrotising enterocolitis [NEC]). Their growth curves and signs of infection were also monitored.
Results:
The average weight gained per week was greater among the infants in Group II than in Group I (120.83 g vs 97.27 g). The incidence of infection was 100% in Group I and 66.6% in Group II. Two of the infants in Group I developed NEC.
Conclusion:
Early enteral feeding helped to improve the weight of ELBW infants. Breast milk was more effective than formula at improving the weight of these infants. Feeding with formula increased the incidence of NEC, invasive infection and morbidity among ELBW infants.
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