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Early Total Enteral Feeding in Stable Very Low Birth Weight Infants: A Before and After Study

Sushma Nangia1, Amit Bishnoi2, Ankita Goel2

  • 1Department of Neonatology, Lady Hardinge Medical College and Kalawati Saran Children Hospital, New Delhi 110001, India.

Journal of Tropical Pediatrics
|April 22, 2017
PubMed

Insights

Early total enteral feeding (ETEF) in very low birth weight (VLBW) infants significantly reduced the time to full feeds and decreased necrotizing enterocolitis (NEC) and sepsis. This feeding strategy is safe and optimizes nutrition for preterm neonates.

Area of Science:

  • Neonatalogy
  • Pediatric Gastroenterology
  • Nutritional Support

Background:

  • Delayed enteral feeding in very low birth weight (VLBW) infants increases risks associated with parenteral nutrition.
  • Necrotizing enterocolitis (NEC) is a primary concern driving cautious feeding practices.

Purpose of the Study:

  • To evaluate the impact of early total enteral feeding (ETEF) on achieving full enteral feeds.
  • To assess the effects of ETEF on feed intolerance, NEC, and sepsis in VLBW infants.

Main Methods:

  • A study involving 208 stable VLBW neonates (28-34 weeks) over three years.
  • Phase 1: Standard care with slow enteral feeding. Phase 2: Implementation of ETEF from Day 1.
  • Phase 3: Assessed sustainability of the ETEF practice.

Main Results:

  • Significantly earlier achievement of full feeds in ETEF phases (5.47-8.97 days) compared to standard care (14.44 days).
  • Reduced incidence of NEC (4% vs 14%) and sepsis in the ETEF group.
  • Decreased duration of parenteral fluid and antibiotic therapy, and shorter hospital stays.

Conclusions:

  • Early total enteral feeding (ETEF) is a safe and beneficial strategy for stable preterm VLBW infants.
  • ETEF optimizes nutrition, leading to reduced NEC, sepsis, and hospital stay.
  • This feeding approach supports improved outcomes in high-risk neonates.
Abstract

Keywords:
early total enteral feedingnecrotizing enterocolitissepsisvery low birth weight

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