Continuous nasogastric milk feeding versus intermittent bolus milk feeding for premature infants less than 1500 grams

Premji, Shahirose; Chessell, Lorraine

doi:10.1002/14651858.cd001819

Cited by 56 publications

(46 citation statements)

References 19 publications

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“…A Cochrane Review comparing clinical effects of continuous and intermittent bolus nasogastric milk feeding in VLBW infants was inconclusive. 1 In the present study, we compared the effect of bolus feeding and continuous feeding on postprandial perfusion and oxygenation using a randomized cross-over design, stratified by IUGR. Doppler US examination showed significantly increased BFV after bolus and continuous feedings, but the increases in all BFV measures were significantly higher after bolus feeding, consistent with previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…In many neonatal intensive care units (NICUs), feeds are administrated by bolus or continuous infusion without any standardized protocol. 1 There are theoretical benefits and risks with both kinds of feedings. Continuous enteral feeding might reduce feeding intolerance, improve nutrient absorption, and improve growth; however, it also could alter the cyclical pattern of release of gastrointestinal and pancreatic hormones and possibly interfere with growth.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Impact of Continuous vs Bolus Feeding on Splanchnic Perfusion in Very Low Birth Weight Infants: A Randomized Trial

Bozzetti

Paterlini

Lorenzo

et al. 2016

The Journal of Pediatrics

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Impact of Continuous vs Bolus Feeding on Splanchnic Perfusion in Very Low Birth Weight Infants: A Randomized Trial

Bozzetti

Paterlini

Lorenzo

et al. 2016

The Journal of Pediatrics

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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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“…Differences between continuous and bolus tube feeding in terms of weight gain, days to full enteral feeding achievement, feeding tolerance, and effect on necrotizing enterocolitis have been largely investigated. Currently, however, there is no clear evidence regarding the method that is better tolerated (7). The effect of the two feeding techniques on cerebral and splanchnic oxygenation has not been extensively investigated.…”

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confidence: 99%

Bolus vs. continuous feeding: effects on splanchnic and cerebral tissue oxygenation in healthy preterm infants

et al. 2014

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Background: Intermittent and continuous tube feeding modes are commonly used to feed preterm infants. However, there is no clear evidence regarding which method is better tolerated. We investigated the differences between bolus and continuous feeding in terms of cerebral and splanchnic oxygenation in healthy preterm infants. Methods: Thirty preterm infants underwent a simultaneous 6-h near-infrared-spectroscopy monitoring of cerebral and splanchnic oxygenation, during which they were fed twice through an orogastric tube: one meal was given as a 10-min bolus, and the other was given continuously over a period of 3 h. Oxygenation trends over time were evaluated and compared between bolus and continuous feeding modes. results: Cerebral oxygenation did not change over time and did not differ between the two feeding techniques. Splanchnic oxygenation changed significantly over time and differed between the two feeding techniques, with a significant increase after bolus feeding and a remarkable reduction during continuous feeding. conclusion: Bolus and continuous feeding modes influence splanchnic oxygenation in healthy preterm infants differently. Further studies are needed to investigate possible underlying mechanisms and potential effects on feeding tolerance.n eonatal care has substantially improved over the past decades, leading to a significant increase in the survival rate of very preterm infants (1). Enteral nutrition is essential for the development of the gastrointestinal tract in the preterm population because it improves intestinal motor activity (2), enhances the release of gastrointestinal hormones with trophic effects (3), and ameliorates feeding tolerance (4). However, very preterm infants are unable to coordinate sucking, swallowing, and breathing (5); thus, they are usually fed via an intragastric tube, continuously or through intermittent boluses (6). Differences between continuous and bolus tube feeding in terms of weight gain, days to full enteral feeding achievement, feeding tolerance, and effect on necrotizing enterocolitis have been largely investigated. Currently, however, there is no clear evidence regarding the method that is better tolerated (7). The effect of the two feeding techniques on cerebral and splanchnic oxygenation has not been extensively investigated. Regional tissue oxygenation results from a dynamic balance between oxygen supply and consumption; thus, a reduction in this parameter might reflect an impairment of systemic oxygen saturation (e.g., due to the occurrence of apneic episodes (8)), a decreased cardiac output leading to a reduction of peripheral perfusion (9), a hemodynamic variation within the examined tissue (e.g., regional vasoconstriction/vasodilatation), or a higher oxygen consumption required to satisfy the metabolic demand (10).Near-infrared spectroscopy (NIRS) is a noninvasive technique based on the near-infrared light absorption spectra of cytochromes, which provides a continuous monitoring of regional tissue oxygenation by measuring the levels of oxygenated a...

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Continuous nasogastric milk feeding versus intermittent bolus milk feeding for premature infants less than 1500 grams

Cited by 56 publications

References 19 publications

Impact of Continuous vs Bolus Feeding on Splanchnic Perfusion in Very Low Birth Weight Infants: A Randomized Trial

Impact of Continuous vs Bolus Feeding on Splanchnic Perfusion in Very Low Birth Weight Infants: A Randomized Trial

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

Bolus vs. continuous feeding: effects on splanchnic and cerebral tissue oxygenation in healthy preterm infants

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