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Feasibility of exclusive enteral feeds from birth in VLBW infants >1200 g – an RCT


  • Trial registration number: Ref No CTRI/2012/04/002570


Kishore Pratap Sanghvi, M.D.,

MA, Sonkamal, 220-C, Walkeshwar Road, Mumbai 400006, India.

Tel: +91-9820019862 |

Fax: +91-22-6657-3035 |




To evaluate the feasibility of initiation of exclusive enteral feeds on first day of life in very low birthweight infants >1200 g.


Haemodynamically stable infants with birthweights 1200–1500 g irrespective of gestational age were randomized into two groups. Study group: Enteral feeds 80 mL/kg/day started within 1 h of birth and increased by 20 mL/kg/day to 180 mL/kg/day. No intravenous fluids given. Control group: Intravenous fluids 50 mL/kg/day started along with enteral feeds 30 mL/kg/day within 1 h of birth and increased by 20 mL/kg/day to 180 mL/kg/day. The outcome measures were – primary: time to regain birthweight and secondary: duration of hospital stay, incidence of necrotizing enterocolitis and sepsis.


Twenty three babies randomized in each group. Infants in study group regained birthweight earlier [mean 5.52 days, SD ± 2.94] compared to those in control group [mean 12.7 days, SD ± 2.25] (p < 0.0001). Duration of hospital stay was lower in study group [mean 15.04 days, SD ± 5.26] compared to those in control group [mean 28.04 days, SD ± 6.76] (p < 0.0001). No necrotizing enterocolitis detected.


It is feasible to initiate exclusive enteral feeds from first day of life in stable infants with birthweight between 1200 and 1500 g without any parenteral fluid support. It leads to twice as faster regaining of birthweight and halves duration of hospital stay.