Minimal enteral feeding reduces the risk of sepsis in feed-intolerant very low birth weight newborns
Article first published online: 22 AUG 2008
©2008 The Author(s)/Journal Compilation ©2008 Foundation Acta Pædiatrica/Acta Pædiatrica
Volume 98, Issue 1, pages 31–35, January 2009
How to Cite
Terrin, G., Passariello, A., Canani, R. B., Manguso, F., Paludetto, R. and Cascioli, C. (2009), Minimal enteral feeding reduces the risk of sepsis in feed-intolerant very low birth weight newborns. Acta Paediatrica, 98: 31–35. doi: 10.1111/j.1651-2227.2008.00987.x
- Issue published online: 9 DEC 2008
- Article first published online: 22 AUG 2008
- Received 12 February 2008; revised 14 July 2008; accepted 17 July 2008.
- Gastric residuals;
- Necrotizing enterocolitis;
- Parenteral nutrition;
- Preterm neonates
Aims: To evaluate the efficacy and safety of minimal enteral feeding (MEF) nutritional practice in feed-intolerant very low birth weight (VLBW) infants.
Methods: A retrospective design using data reported in the clinical charts of VLBW newborns consecutively observed in neonatal intensive care units (NICU) that presents feed intolerance. During the study period, two feeding strategies were adopted: total parenteral nutrition (PN) (group 1) or PN plus MEF (group 2), for at least 24 h. Primary outcome was the time to reach full enteral feeding; secondary outcomes were the occurrence of sepsis, the time to regain birth weight, the length of hospitalization, the occurrence of necrotizing enterocolitis (NEC) Bell stage >II and death.
Results: In total, 102 newborns were evaluated: 51 in group 1, and 51 in group 2. Neonates in group 2 achieved full enteral nutrition earlier (8 days, interquartile range [IQR] 5) compared with subjects receiving total PN (11 days, IQR 5, p < 0.001). A reduction of sepsis episodes was observed in group 2 (15.7%) compared with group 1 (33.3%, p = 0.038). Additionally, subjects in group 2 regained their birth weight and were discharged earlier. The occurrence of NEC and death were similar in the two groups.
Conclusion: Minimal enteral feeding in very low birth weight infants presenting feed intolerance reduces the time to reach full enteral feeding and the risk of sepsis. This feeding practice does not increase the risk of necrotizing enterocolitis and death.