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Neonatal Fetal Nutrition & Metabolism

Neonatal GI Physiology & NEC 4: Gut Health, Enteral Nutrition and Oral Feeding

86 - Comparison of Three Modalities of Feeding in Preterm Infants ≤ 32 weeks and ≤1250 g: A Randomized Controlled Trial

Saturday, April 29, 2023

3:30 PM – 6:00 PM ET

Poster Number: 86
Publication Number: 86.236

Neelam Kler, Sir Ganga Ram Hospital, New Delhi, New Delhi, Delhi, India; vijay kumar, IMS and SUM hospital, Bengaluru, Karnataka, India; Anup Thakur, Sir Ganga Ram Hospital, New Delhi, New Delhi, Delhi, India; Pankaj Garg, SIR GANGA RAM HOSPITAL, NEW DELHI, DELHI, Delhi, India

Presenting Author(s)

NK

Neelam Kler, n/a (she/her/hers)

Sir Ganga Ram Hospital, New Delhi
New Delhi, Delhi, India

Background: Early establishment of enteral feeds is desirable in very preterm infants, but it may be associated with feed intolerance and necrotizing enterocolitis. Several feeding methods have been studied with no strong evidence to suggest the preferred feeding method to establish early full feeds.

Objective: We studied three modalities of feeding in preterm infants ≤ 32wk and ≤1250g- continuous infusion (CI), intermittent bolus by infusion (IBI) and intermittent bolus by gravity (IBG) for their effect on time to reach full enteral feeds.

Design/Methods: We randomised 146 infants, 49 infants in each CI and IBI group and 48 infants in the IBG group. In the CI group, feeds were delivered by an infusion pump continuously over 24 hours. In the IBI group, feeds were given every 2 hours and infused over 15 minutes by an infusion pump. In IBG group, feeds were delivered by gravity over 10-30 minutes. The intervention was continued till infants reached total direct feeds.

Results:

The mean (SD) gestation in CI, IBI and IBG groups were 28.4 (2.2) wk, 28.5(1.9) wk and 28.6 (1.8) wk, respectively. The time to reach full feeds in CI, IBI and IBG were not significantly different [median (IQR) 13(10-16), 11.5(9-17) and 13(9.5-14.2) days respectively, (p=0.71)]. The proportion of infants who developed feed intolerance in CI, IBI and IBG were similar [n (%) 21 (51.2%), 20(52.6%) and 22(64.7%), respectively, (p=0.45)]. There was no difference in morbidities and growth parameters at discharge.

Conclusion(s):

In preterm infants, ≤ 32wk of gestation and birth weight ≤ 1250g, there was no difference in time to reach full enteral feeds in the three modalities of feeding.