Open AccessDoes the Enteral Feeding Advancement Affect Short‐term Outcomes in Very Low Birth Weight Infants?
Author(s) -
Härtel Christoph,
Haase Berit,
BrowningCarmo Kathryn,
Gebauer Corinna,
Kattner Evelyn,
Kribs Angela,
Segerer Hugo,
Teig Norbert,
Wense Axel von der,
Wieg Christian,
Herting Egbert,
Göpel Wolfgang
Publication year - 2009
Publication title -
journal of pediatric gastroenterology and nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 131
eISSN - 1536-4801
pISSN - 0277-2116
DOI - 10.1097/mpg.0b013e31818c5fc3
Subject(s) - medicine , enteral administration , sepsis , necrotizing enterocolitis , parenteral nutrition , pediatrics , low birth weight , prospective cohort study , regimen , neonatal intensive care unit , intensive care medicine , pregnancy , biology , genetics
ABSTRACT Background and Objectives: Controversy exists regarding the optimal enteral feeding regimen of very low birth weight infants (VLBW). Rapid advancement of enteral feeding has been associated with an increased rate of necrotizing enterocolitis. In contrast, delaying enteral feeding may have unfavorable effects on nutrition, growth, and neurodevelopment. The aim is to compare the short‐term outcomes of VLBW infants in tertiary care centers according to their enteral feeding advancement. Patients and Methods: We prospectively studied the influence of center‐specific enteral feeding advancement in 1430 VLBW infants recruited from 13 tertiary neonatal intensive care units in Germany on short‐term outcome parameters. The centers were post hoc stratified to “rapid advancement to full enteral feeds” (median duration of advancement to full enteral feeds ≤12.5 days; 6 centers), that is, rapid advancement (RA), or “slow advancement to full enteral feeds” (median duration of advancement to full enteral feeds >12.5 days; 7 centers), that is, slow advancement (SA). Results: VLBW infants born in centers with SA (n = 713) had a significantly higher rate of sepsis compared with VLBW infants born in centers with RA (n = 717), which was particularly evident for late‐onset sepsis (14.0% vs 20.4%; P = 0.002). Furthermore, more central venous lines (48.6% vs 31.1%, P < 0.001) and antibiotics (92.4% vs 77.7%, P < 0.001) were used in centers with SA. Conclusions: Center differences in enteral feeding advancement occur and may have a significant impact on short‐term outcomes such as nosocomial sepsis. Large, multicenter, prospective trials are required to further elucidate the optimal feeding strategy for VLBW infants.