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Continuous feeding versus intermittent bolus feeding for premature infants with low birth weight: a meta-analysis of
Yan Wang1,2, Wei Zhu2, Bi-Ru Luo3
1Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.
Insights
Intermittent feeding may be more beneficial for low-birth-weight infants, as continuous feeding prolonged the time to achieve full feeds. Further research is needed to confirm the optimal feeding strategy for premature infants.
Area of Science:
- Neonatal Nutrition
- Pediatric Gastroenterology
- Clinical Nutrition
Background:
- Previous studies have explored clinical risks and advantages of continuous versus intermittent feeding in preterm infants.
- Determining the optimal feeding method for low-birth-weight infants is crucial for their development.
Purpose of the Study:
- To conduct a meta-analysis to determine the most appropriate feeding method for low-birth-weight infants.
- To compare continuous feeding versus intermittent feeding in preterm infants.
Main Methods:
- A systematic literature search was performed in PubMed, EMBASE, and Cochrane Library up to May 2019.
- Eight articles involving 707 infants were included in the meta-analysis.
- Heterogeneity was assessed using Chi-square and I-squared tests, with fixed or random effects models applied accordingly. Study quality was evaluated using the Cochrane assessment tool.
Main Results:
- Continuous feeding was associated with a longer time to achieve full feeds (mean difference 0.98 days) compared to intermittent feeding.
- No significant differences were observed in feeding intolerance, hospitalization duration, time to regain birth weight, or necrotizing enterocolitis rates.
- Subgroup analysis by birth weight (<1000g and >1000g) did not reveal significant differences in key feeding outcomes.
Conclusions:
- Intermittent feeding may offer benefits for low-birth-weight infants.
- Further well-designed studies are necessary to establish evidence-based clinical practices for feeding premature infants.
Background/Objectives:
Clinical risks and advantages of both continuous feeding and intermittent feeding for preterm infants have been presented in previous studies. To determine the most appropriate feeding method for low-birth-weight infants, a meta-analysis was conducted.
Subjects/Methods:
Articles related to this topic were searched in PubMed, EMBASE, and Cochrane Library electronic database from the onset to May 2019. Heterogeneity analysis was performed with Chi-square and I2 test. Pooled analysis was based on fixed effects model, if heterogeneity between the eligible studies was negligible (I2 < 50%, P > 0.05). In contrast, a random effects model was carried out. The quality of including studies were evaluated by Cochrane assessment tool.
Results:
A total of 1030 articles identified. Altogether, eight articles including 707 infants were included in final analysis based on eligibility criteria. In continuous feeding infants, time to achieving full feeds was longer (weight mean difference 0.98 (95% CI 0.26-1.71, P = 0.008) days) compared with intermittent feeding infants. Pooled analysis indicated there were no significant difference in other variables such as feeding intolerance, duration of hospitalization, days to regain birth weight, days to first successful oral feeding, duration of parenteral feeding, weight growth, length increment, head circumference growth, proven necrotizing enterocolitis, and probable necrotizing enterocolitis. In subgroup analysis for birth weight (<1000 g and >1000 g), we did not identify significant difference in time to full feeds, time to regain birth weight, and duration of hospitalization.
Conclusions:
Intermittent feeding may be more beneficial for low-birth weight infants, However, well-designed studies and evidenced-based clinical practice are required to determine the most appropriate feeding method for premature infants with low birth weight.
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