Related Experiment Video
Updated: Nov 27, 2025
Breast Milk Enhances Growth of Enteroids: An Ex Vivo Model of Cell Proliferation
Published on: February 15, 2018
Effects of standardized feeding protocol on growth velocity and necrotizing enterocolitis in extremely low birth
Sanket D Shah1, Natalie Booth2, Padma Nandula3
1Division of Neonatology, Department of Pediatrics, University of Florida College of Medicine, Jacksonville, FL, USA. sdshah_5@yahoo.com.
Insights
A standardized feeding protocol (SFP) improved growth velocity (GV) in extremely low birth weight infants by 36 weeks
Area of Science:
- Neonatal care
- Pediatric gastroenterology
- Neonatal nutrition
Background:
- Extremely low birth weight (ELBW) infants are at high risk for gastrointestinal complications, including necrotizing enterocolitis (NEC).
- Standardized feeding protocols (SFPs) are increasingly implemented to optimize nutrition and reduce morbidities in vulnerable infant populations.
- Evidence regarding the impact of SFPs on growth and NEC in ELBW infants requires further investigation.
Purpose of the Study:
- To evaluate the effect of a standardized feeding protocol (SFP) on growth velocity (GV) and the incidence of necrotizing enterocolitis (NEC) in extremely low birth weight (ELBW) infants.
Main Methods:
- A retrospective cohort study compared outcomes before and after the implementation of an SFP.
- Data from 145 infants (cohort 1) before SFP and 69 infants (cohort 2) after SFP were analyzed.
- Growth velocity, nutritional intake, and gastrointestinal complications were assessed.
Main Results:
- Median growth velocity at 36 weeks' postmenstrual age (PMA) was significantly higher in the SFP group (cohort 2) compared to the pre-SFP group (cohort 1).
- The adjusted odds of developing NEC were significantly lower (63% reduction) in infants managed under the SFP.
- No significant difference in weekly GV was observed during the first four weeks of life between the cohorts.
Conclusions:
- Implementation of a standardized feeding protocol is associated with improved growth velocity in ELBW infants.
- The SFP demonstrated a significant reduction in the adjusted odds of necrotizing enterocolitis in this cohort.
- These findings suggest that SFPs can be a valuable tool in managing ELBW infants and improving their outcomes.
Objective:
To assess the effect of a standardized feeding protocol (SFP) on growth velocity (GV) and necrotizing enterocolitis (NEC) in extremely low birth weight infants.
Methods:
This single-study center retrospectively compared growth, nutritional, and gastrointestinal outcomes in two infant cohorts before (cohort 1; n = 145) and after (cohort 2; n = 69) SFP implementation.
Results:
Although weekly GV in the first 4 weeks of life did not differ between the two cohorts, median GV at 36 weeks' post-menstrual age (PMA) was higher in cohort 2 compared with cohort 1 (26.8 g/day [24.7, 28.9] vs 24.9 g/day [22.9, 28.3], p = 0.02). The odds of NEC were lower in cohort 2 by 63% after adjusting for birth weight, small-for-gestational-age, and gender (OR = 0.38, 95% CI 0.142-0.993, p = 0.047).
Conclusion:
Our SFP was associated with improved GV at 36 weeks' PMA and a lower adjusted rate of NEC.
