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Early exclusive enteral feeding in 30-33 weeks gestation infants: a randomized controlled trial
Belal N Alshaikh1,2, Ossama Hassan3, Wissam Alburaki4,5
1Neonatal Gastroenterology and Nutrition Program, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. balshaik@ucalgary.ca.
Insights
Early exclusive enteral feeding (EEEF) for preterm infants is feasible and effective. This approach significantly reduces the time to reach full enteral feeds and shortens hospital stays.
Area of Science:
- Neonatal nutrition
- Pediatric gastroenterology
- Clinical trial research
Background:
- Preterm infants often require specialized feeding strategies.
- Optimizing nutrition delivery is crucial for infant development and health outcomes.
- ClinicalTrials.gov identifier: NCT03708068.
Purpose of the Study:
- To assess the feasibility and efficacy of early exclusive enteral feeding (EEEF).
- To determine if EEEF can reduce the time to achieve full enteral feeds in preterm infants.
Main Methods:
- A pragmatic randomized controlled trial involving infants born between 30 0/7 and 33 6/7 weeks gestation.
- Infants were randomized to receive either EEEF or conventional feeding with intravenous fluids.
- Feed volumes were progressively increased in both groups.
Main Results:
- Infants in the EEEF group reached full enteral feeds faster (Mean difference -1.2 days).
- EEEF significantly reduced the need for parenteral nutrition and central venous access.
- Hospital stays were shorter for infants receiving EEEF (Mean difference -6.6 days).
Conclusions:
- Early exclusive enteral feeding is a feasible and beneficial strategy for preterm infants.
- EEEF accelerates achievement of full enteral feeds and reduces overall hospitalization duration.
- This feeding approach offers significant clinical advantages for moderately preterm infants.
Objective:
To evaluate feasibility and efficacy of early exclusive enteral feeding (EEEF) in reducing time to achieve full enteral feeds.
Methods:
A pragmatic randomized controlled trial of infants born at 300/7-336/7 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.
Results:
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].
Conclusion:
Early exclusive enteral feeding in 300/7-336/7 weeks gestation infants is feasible and reduces time required to achieve full enteral feeds and length of hospital stay.
Trial Registration:
ClinicalTrials.gov: NCT03708068.
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