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
