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.

BMJ Paediatrics Open
|April 12, 2018
PubMed

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.
Abstract

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