Early versus Late Trophic Feeding in Very Low Birth Weight Preterm Infants|
Sallakh-Niknezhad, Akram; Bashar-Hashemi, Fazileh; Satarzadeh, Niloofar; Ghojazadeh, Morteza & Sahnazarli, Golnesa
Objective: Improved survival of preterm infants, beneficial effects of trophic feeding and limited data on
timing management of enteral feeding for very low birth weight preterm infants requires more researches to
determine the exact starting time and increased volumes. This study aims to compare early (<48 h) versus
late ( >72h) trophic feeding with respect to important neonatal outcomes.
Methods: In a cohort study from September 2007 to October 2008, a total of 170 preterm infants (1000-1500
gram, 26-31 weeks) consisting of 125 who received trophic feeding enterally within the first 48 hours of birth
(early group) and 45 fed enterally after 72 h0urs (late group), without major congenital birth defects and
severe asphyxia entered the study. Bolus feeding was started in both groups at 1-2 cc/kg every 4-6 hours of
human milk or preterm infant formula and was advanced 1-2 cc/kg/day if tolerated along with parenteral
nutrition. Feeding intolerance, possibility of necrotizing entrocolitis (NEC), episodes of sepsis, body weight,
length of NICU stay, and duration of parenteral nutrition were assessed serially.
Findings: There were no statistically significant differences in the clinical and maternal characteristics of
infants in the two groups. The time to gain birth weight (13.75±5.21 vs 20.53±6.31 (P <0.001)), duration of
parenteral nutrition (9.26±4.572 days vs 14.11±6.415 days (P <0.001)), hospital stay (12.14±8.612 vs
21.11±1.156 (P <0.001)) were significantly shorter in early compared to late feeding group; none of the two
groups experienced a high incidence of late onset sepsis (P=0.73). There was 1 case of confirmed NEC in every
Conclusion: The benefits of early trophic feeding shown by this study strongly support its use for the preterm
infants without adding to complications.
Trophic Feeding; Preterm Infant; Very Low Birth Weight Infant; Parenteral Nutrition