Randomised trial of continuous nasogastric, bolus nasogastric, and transpyloric feeding in infants of birth weight under 1400 g.

Abstract

This study compares the growth of babies randomised to receive one of three methods of feeding: hourly bolus nasogastric feeding (bNG), continuous nasogastric feeding (cNG) and continuous transpyloric feeding (TP).

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

“…18,19 Time to achieve full enteral feeding is an indicator for gastrointestinal tolerance and it was used as an endpoint in several studies. 12,[20][21][22][23] However, the definition of time to achieve full enteral feeding differs widely. The question of whether different feeding strategies have an effect on gastrointestinal tolerance and growth has been raised by several authors, but the results of previous studies are limited and conflicting.…”

“…The question of whether different feeding strategies have an effect on gastrointestinal tolerance and growth has been raised by several authors, but the results of previous studies are limited and conflicting. 12,[20][21][22][23][24] To our knowledge, only 1 study 23 has compared continuous versus intermittent feeding in infants with gestational age (GA) as low as 24 weeks. It is therefore of importance to know whether the mode of feeding (continuous versus intermittent) promotes gastrointestinal tolerance and growth in this specific group of very immature infants.…”

Enteral feeding in infants <1250 g starting within 24 h post-partum

“…The important ®nding in this study is that infants of birth weight <1250 g can be fed mother's milk already from the 1st day of life and attain full feeds considerably faster than has previously been reported for comparable and even more mature infants [1,3,7,14,19]. Since the infants included in this study were treated at two different hospitals, factors other than dierent feeding approaches may have in¯uenced the results, which is a weakness of the study.…”

“…In previous reports on early enteral feeding,``early'' has been any day between the 2nd and 8th day of life (mean 32 days) [1,3,6,7,14,16,19,20,21,23]. Early enteral feeding is suggested to enhance priming of the gut making it more apt to absorb nutrients [9,16,19].…”

“…The most common methods used are continuous intragastric milk infusion, intermittent (bolus) feeding or a combination of both. Data on which method is optimal in respect to gastrointestinal tolerance and somatic growth are limited and con¯icting [1,14,19,20,23].…”