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Techniques of enteral feeding in the newborn
1Division of Neonatology, Udine General Hospital, Italy.
Insights
Gastric bolus feeding is practical for newborns, while continuous gastric feeding benefits unstable preterm infants. Early, low-volume enteral feedings and gradual increases are safe, reducing risks like necrotizing enterocolitis.
Area of Science:
- Neonatal nutrition
- Pediatric gastroenterology
Background:
- Gastric bolus feeding is a common, cost-effective enteral nutrition method for newborns.
- Certain infants, including preterm or those with respiratory issues, may require alternative feeding strategies.
Purpose of the Study:
- To evaluate the efficacy and safety of different enteral feeding techniques in neonates.
- To determine optimal feeding volumes and advancement rates for newborn infants.
Main Methods:
- Review of current literature on neonatal enteral feeding practices.
- Analysis of outcomes associated with gastric bolus, continuous gastric, and transpyloric feeding methods.
Main Results:
- Gastric bolus feeding is preferred for most newborns due to practicality and cost.
- Continuous gastric feeding may be advantageous for unstable preterm infants or those with delayed gastric emptying.
- Transpyloric feeding is reserved for infants at high risk of aspiration.
- Early, low-volume feedings are beneficial and do not increase morbidity.
- Daily feeding increments of 10-20 ml/kg are safe and do not elevate the risk of necrotizing enterocolitis.
Conclusions:
- The choice of enteral feeding method should be individualized based on infant stability and specific medical conditions.
- Gradual advancement of enteral feeds is a safe practice in neonatal care.
Abstract:
Among techniques of enteral feeding, gastric bolus feeding still appears to be the method of choice for most newborn babies because it is both practical and inexpensive. Unstable preterm infants and those with severe respiratory diseases or with delayed gastric emptying time may not tolerate intermittent gastric feedings and may benefit from continuous gastric feedings. Transpyloric feedings do not seem to offer any advantage over continuous gastric feedings and should be reserved for infants at risk of aspiration, such as those with gastroesophageal reflux or delayed gastric emptying. Early low-volume feedings appear beneficial and are not associated with increased morbidity. Once enteral feedings are established, daily increments of 10-20 ml/kg appear to be safe and not associated with an increased risk of necrotizing enterocolitis.