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Published on: January 7, 2020
Multicentre prospective observational study of feeding practices in 30-33 weeks preterm infants
T C Kwok1, Jon Dorling1, Shalini Ojha2
1Academic Division of Child Health, University of Nottingham, Nottingham, UK.
Insights
Starting total enteral feeding from birth is feasible in preterm infants (30-33 weeks gestation). Early feeding within 24 hours led to quicker full feeds and shorter hospital stays, suggesting current practices may be conservative.
Area of Science:
- Neonatal Nutrition
- Pediatric Gastroenterology
- Perinatal Medicine
Background:
- Progressive feeding is standard for preterm infants.
- Recent evidence suggests early total enteral feeding may reduce necrotising enterocolitis risk in infants born at 30-33 weeks gestation.
- The feasibility of initiating total enteral feeding from birth in this population requires investigation.
Purpose of the Study:
- To explore current feeding practices in preterm infants born between 30 and 33 weeks gestation.
- To assess the feasibility and outcomes of early enteral feeding initiation in this cohort.
Main Methods:
- Prospective, multicentre, observational study design.
- Inclusion of 10 consecutive preterm infants (30-33 weeks gestation) from eight UK hospitals.
- Data collection on feeding initiation, achievement of total enteral and full feeds, and associated outcomes.
Main Results:
- Eighty infants received their first enteral feed at a median of 24 hours.
- Median time to achieve total enteral feeding (without IV nutrition) was 5 days, and full feeds (≥150 ml/kg/day) was 8 days.
- Infants achieving total enteral feeding within 24 hours reached full feeds earlier (p=0.02) and had shorter hospital stays (p=0.009), though they were of slightly older gestation (p=0.004).
Conclusions:
- Current feeding practices for 30-33 weeks gestation preterm infants appear conservative.
- Initiating total enteral feeding from birth is achievable in this population.
- Further research is warranted to optimize early feeding protocols for improved outcomes.
Background:
Current evidence supports progressive feeding in preterm infants. Due to lower necrotising enterocolitis risk, recent studies suggest starting total enteral feeding from birth in 30-33 weeks preterm infants. The feasibility of this practice is unclear.
Aim:
Explore feeding practices in 30-33 weeks preterm infants.
Design:
Prospective, multicentre, observational study recruiting 10 consecutive 30-33 weeks preterm infants from each of the eight UK hospitals.
Results:
Eighty infants received their first feed at median of 24 hours, achieving total enteral (without intravenous nutrition) and full feeds (≥150 ml/kg/day) at median of 5 and 8 days, respectively. Eleven infants who achieved total enteral feeding within 24 hours after birth achieved full feeds earlier (p=0.02) with shorter hospital stay (p=0.009) but were also of older gestation (p=0.004).
Conclusion:
Current early feeding approaches in 30-33 weeks preterm infants were found to be conservative. Total enteral feeding from birth is possible in these infants but further studies are needed.
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