Early exclusive enteral feeding in 30-33 weeks gestation infants: a randomized controlled trial

To evaluate feasibility and efficacy of early exclusive enteral feeding (EEEF) in reducing time to achieve full enteral feeds.

A pragmatic randomized controlled trial of infants born at 30^0/7-33^6/7 weeks gestation. Infants were randomly assigned to receive EEEF (60-80 mL/kg/day) or conventional feeding (20-30 mL/kg/day) with intravenous fluids after birth. Feed volumes were increased by 20-30 mL/kg/day. Primary outcome was time to reach full enteral feeds.

Seventy infants were enrolled. Infants in EEEF group achieved full feeds sooner [Mean difference (MD) -1.2 (95%CI -1.8, -0.7)], required fewer hours of parenteral nutrition [0 (IQR 0, 19) vs. 91 (IQR 48, 132) hours, P < 0.001], had less need for central venous access (11.4% vs. 37.1%, P = 0.01) and had shorter hospital stays [MD -6.6 (95%CI -12.9, -0.2) days].

Early exclusive enteral feeding in 30^0/7-33^6/7 weeks gestation infants is feasible and reduces time required to achieve full enteral feeds and length of hospital stay.

ClinicalTrials.gov: NCT03708068.