Continuous Feeding Promotes Gastrointestinal Tolerance and Growth in Very Low Birth Weight Infants

Dsilna, Ann; Christensson, Kyllike; Alfredsson, Lars; Lagercrantz, Hugo; Blennow, Mats

doi:10.1016/j.jpeds.2005.03.003

Cited by 81 publications

(76 citation statements)

References 35 publications

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“…In the current study, protein deposition was greater in pigs fed intermittently compared with those fed continuously. This contrasts with one study where human neonates fed continuously showed faster linear growth (based on lower leg length) compared with those fed intermittently, although weight gains were similar (23). However, most studies show that intermittent feeding results in equal (2,40,55) or better (53) weight gain than continuous feeding.…”

Section: Discussionmentioning

confidence: 63%

Anabolic signaling and protein deposition are enhanced by intermittent compared with continuous feeding in skeletal muscle of neonates

El‐Kadi

Suryawan

Gazzaneo

et al. 2012

American Journal of Physiology-Endocrinology and Metabolism

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Orogastric tube feeding is indicated for neonates with impaired ability to ingest and can be administered by intermittent bolus or continuous schedule. Our aim was to determine whether feeding modalities affect muscle protein deposition and to identify mechanisms involved. Neonatal pigs were overnight fasted (FAS) or fed the same amount of food continuously (CON) or intermittently (INT; 7 × 4 h meals) for 29 h. For 8 h, between hours 20 and 28, pigs were infused with [(2)H(5)]phenylalanine and [(2)H(2)]tyrosine, and amino acid (AA) net balances were measured across the hindquarters. Insulin, branched-chain AA, phenylalanine, and tyrosine arterial concentrations and whole body phenylalanine and tyrosine fluxes were greater for INT after the meal than for CON or FAS. The activation of signaling proteins leading to initiation of mRNA translation, including eukaryotic initiation factor (eIF)4E·eIF4G complex formation in muscle, was enhanced by INT compared with CON feeding or FAS. Signaling proteins of protein degradation were not affected by feeding modalities except for microtubule-associated protein light chain 3-II, which was highest in the FAS. Across the hindquarters, AA net removal increased for INT but not for CON or FAS, with protein deposition greater for INT. This was because protein synthesis increased following feeding for INT but remained unchanged for CON and FAS, whereas there was no change in protein degradation across any dietary treatment. These results suggest that muscle protein accretion in neonates is enhanced with intermittent bolus to a greater extent than continuous feeding, mainly by increased protein synthesis.

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Section: Discussionmentioning

confidence: 63%

Anabolic signaling and protein deposition are enhanced by intermittent compared with continuous feeding in skeletal muscle of neonates

El‐Kadi

Suryawan

Gazzaneo

et al. 2012

American Journal of Physiology-Endocrinology and Metabolism

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“…Several small studies and a systematic review suggest that intermittent bolus feedingsFcompared with continuous feedingsFimprove feeding tolerance and growth in VLBW infants. [8][9][10][11] Bolus feedings stimulate maturation of hormone secretion and motility in the premature gastrointestinal tract. [12][13][14] Rapidly administered boluses decrease intestinal motor activity, while slowly administered boluses increase activity.…”

Section: Introductionmentioning

confidence: 99%

The impact of feeding interval on feeding outcomes in very low birth-weight infants

2011

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Objective: Test the hypothesis that very low birth-weight (VLBW) infants fed every 2 h (q2) are able to reach full enteral feedings more quickly than infants fed every 3 h (q3).Study Design: We performed a retrospective cohort study comparing q2 infants (n ¼ 103) with q3 infants (n ¼ 251). The primary outcome was days from start of a feeding advance to full feedings (120 ml per kg per day). Multivariable regression models were used to control for maternal and perinatal factors that preceded the initiation of the feeding advance.Result: Infants fed q2 reached full feedings 2.7 days sooner than q3 infants (95% confidence interval (CI) 1.5, 3.9). After adjustment for confounders, q2 infants reached full feedings 3.7 (95% CI 1.6, 5.9) days more quickly. Infants fed q3 were more likely to receive >28 days of parenteral nutrition (odds ratio (OR) 4.7; 95% CI 1.5, 14.4), and were more likely to have feeds held for X7 days (OR 4.7, 95% CI 1.9, 11.7).Conclusion: VLBW infants demonstrate improved feeding tolerance when fed more frequently.

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“…After discharge, the median (range) frequency of breastfeeding sessions of the 24 exclusively breastfed infants was 14 (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26) times per 24 hours including 4 (1-9) times per night. The median frequency of the 16 infants who received breast milk only, by tube, cup, or bottle in addition to breastfeeding, reported a median frequency of 12.5 (6-28) including 4 (2-10) times per night.…”

Section: Breastfeeding Session Frequencies After Dischargementioning

confidence: 99%

“…The infant is then gradually weaned off this method between 32 and 34 weeks postmenstrual age. 20 To provide warmth for the preterm infant, parents and infants are commonly separated by the use of an incubator. Kangaroo mother care (KMC) is a model of care for reducing the separation between preterm infants and their parents and for preventing infant hypothermia.…”

Section: Introductionmentioning

confidence: 99%

Breastfeeding Patterns in Preterm Infants Born at 28-33 Gestational Weeks

et al. 2015

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Continuous Feeding Promotes Gastrointestinal Tolerance and Growth in Very Low Birth Weight Infants

Cited by 81 publications

References 35 publications

Anabolic signaling and protein deposition are enhanced by intermittent compared with continuous feeding in skeletal muscle of neonates

Anabolic signaling and protein deposition are enhanced by intermittent compared with continuous feeding in skeletal muscle of neonates

The impact of feeding interval on feeding outcomes in very low birth-weight infants

Breastfeeding Patterns in Preterm Infants Born at 28-33 Gestational Weeks

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