Clinical Outcomes of Slow versus Rapid Enteral Feeding Advancement in Very Low Birth Weight Neonates at a Tertiary Care Center

Abstract

In India, every year around 3.5 million babies are born premature, accounting for almost 13% of total live
births in the country as compared to 5% to 7% incidence in the West. Preterm is defined as babies born before 37 weeks of
pregnancy. The rapidity of feed volume increments involves controversies like faster weight gain, shorter hospital stays, the
risk of necrotizing enterocolitis and vice versa. Methods: The present study was a randomized controlled trial conducted from
June 1, 2018 to October 31, 2019. All infants in the study were randomized to slow and rapid feeding protocols by a stratified
block randomization sequence of 2, 4, 6 blocks. Group 1 or the slow advancement group included 64 newborns babies and
Group 2 or the rapid advancement group included 69 newborns babies. Results: The average weight gain in Group 1 was
4.41 ± 0.9 g and in Group 2 it was 6.33 ± 1.3 g, the difference was statistically significant (p < 0.02). Sixty out of 64 newborns
regained birth weight within 16.87 ± 0.9 days in Group 1, while 64 out of 69 newborns regained birth weight within 13.63 ±
0.9 days in Group 2. The difference was statistically significant. Increment in the mean occipitofrontal circumference per
week was 0.29 ± 0.27 cm Group 1, while in Group 2 it was 0.42 ± 0.05 cm; the difference was statistically significant. Mean
average length increment per week was found to be 0.55 ± 0.04 cm and 0.69 ± 0.05 cm in Group 1 and Group 2, respectively,
the difference was statistically significant (p < 0.005). The mean duration of hospital stay was 27.47 ± 3.33 days in Group 1
while in Group 2, the duration of stay was 23.15 ± 2.22 days, the difference was statistically significant. Conclusion: Our
study supports enteral nutrition by rapid enteral feeding regimen in stable preterm neonates with very low birth weight