Enteral Feeding and Necrotizing Enterocolitis: Does time of First Feeds and Rate of Advancement matter?
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Read the article on pubmed.ncbi.nlm.nih.gov ↗Article · Apr 2021 · 1 min read
In brief
In brief
Multi-center study of 12,387 very low birth weight infants examines feeding protocols and NEC risk. Slower feeding advancement rates reduced NEC incidence and mortality, while delayed initial feeding showed protective effects for death but not NEC alone.
Written by the GCMD Library team from the article.
Objective: To determine if time to initial enteral feeding (EF) and rate of advancement are associated with necrotizing enterocolitis (NEC) or death.
Methods: Secondary analysis of prospectively collected data of very low birth weight infants (VLBWI: 400- 1,500 g) born in 26 NEOCOSUR centers between 2000-2014.
Results: Among 12,387 VLBWI, 83.7% survived without NEC, 6.6% developed NEC and survived, and 9.6% had NEC and died or died without NEC (NEC/Death). After risk adjustment, time to initial EF (median = 2 days) was not associated with NEC, however delaying it was protective for NEC/Death (OR = 0.96; 95% CI (0.93-0.99)). A slower feeding advancement rate was protective for NEC (OR = 0.97; 95% CI (0.94-0.98)) and for NEC/Death (OR = 0.98; 95% CI (0.96-0.99)).
Conclusions: In VLBWI there was no association between an early initial EF and NEC, although delaying it was associated with less NEC/Death. A slower feeding advancement rate was associated with lower risk of both outcomes.
DOI: 10.1097/MPG.0000000000003069