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Higher- or Usual-Volume Feedings in Infants Born Very Preterm: A Randomized Clinical Trial

Colm P Travers1, Timothy Wang2, Ariel A Salas1

  • 1Department of Pediatrics, Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL.

The Journal of Pediatrics
|May 29, 2020
PubMed

Insights

Higher-volume feedings significantly improved postnatal growth in very preterm infants. This intervention increased growth velocity and key measurements without adverse effects, supporting its use in clinical practice.

Area of Science:

  • Neonatalogy
  • Pediatric Nutrition
  • Growth and Development

Background:

  • Infants born very preterm often experience suboptimal postnatal growth.
  • Optimizing nutritional strategies is crucial for improving outcomes in this vulnerable population.

Purpose of the Study:

  • To evaluate the impact of higher-volume enteral feedings on postnatal growth velocity in very preterm infants.
  • To compare growth parameters and adverse outcomes between higher-volume and usual-volume feeding groups.

Main Methods:

  • A randomized clinical trial involving 224 infants (birth weight 1001-2500g, gestational age <32 weeks) was conducted.
  • Infants were assigned to receive either higher-volume (180-200 mL/kg/d) or usual-volume (140-160 mL/kg/d) enteral feedings.
  • The primary outcome was growth velocity measured from randomization to 36 weeks postmenstrual age or hospital discharge.

Main Results:

  • Higher-volume feedings resulted in significantly increased growth velocity (20.5 vs 17.9 g/kg/d; P < .001).
  • Infants receiving higher-volume feedings showed significantly greater weight, head circumference, length, and mid-arm circumference at study completion.
  • No significant differences in adverse outcomes such as bronchopulmonary dysplasia or necrotizing enterocolitis were observed between the groups.

Conclusions:

  • Higher-volume enteral feedings enhance postnatal growth in very preterm infants weighing 1001-2500g at birth.
  • This feeding strategy improves growth velocity and anthropometric measurements without increasing adverse events.
  • The findings support the implementation of higher-volume feedings for improved growth in this patient population.
Abstract

Keywords:
extrauterinefailurefeedfeeding high enteral nutritionfeedingsfeedsgreatergrowth velocityinfantnewbornpostnatalrestrictionusualvolumeweight

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