A randomized controlled trial on early versus late minimal enteral feeding in preterm growth-restricted neonates with abnormal antenatal Doppler studies
Affiliations: Pediatric Department-NICU, Women's Hospital, Hamad Medical Corporation, Doha, Qatar | Obstetrics and Gynecology Department, Women's Hospital, Hamad Medical Corporation, Doha, Qatar
Note: [] Corresponding author: Dr. Mohamed Abdelmaaboud, Hamad Medical Corporation, Women Hospital, Department of Pediatrics-NICU, P.B. 3050 Doha, Qatar. Tel.: +974 66730949; Fax: +974 4393619; E-mail: dr_mohamed318@hotmail.com
Abstract: Background: Preterm and growth-restricted babies are at high risk of milk intolerance and necrotizing enterocolitis (NEC). Currently, there is a lack of published literature on ideal feeding practices for this study population. Objective: To evaluate the effects of an “early” enteral feeding regimen at the start of day 2 after birth compared to late enteral feeding and at the start of day 6 after birth in preterm growth restricted babies with abnormal antenatal Doppler studies regarding the incidence of NEC and feeding intolerance. Patients and methods: Babies with gestational age below 37 weeks and birth weight below the 10th percentile for gestational age, were randomly allocated to an “early” or “late” enteral feeding regimen. Feeds were gradually increased using a feeding protocol used in Neonatal Intensive Care Unit, Women's Hospital, Hamad Medical Corporation. Results: Maternal demographic data as well as cases of NEC and feeding intolerance were all recorded. One hundred twenty-five infants were enrolled in the study: 62 received early feeding and 63 received delayed feeding. The incidence of NEC and feeding intolerance were not significantly different between the two groups. Birth weight was an independent risk factor for NEC in both groups. Conclusion: Early minimal enteral feeding (MEF) of preterm and small for gestational age infants with abnormal antenatal Doppler findings may not have a significant effect on the incidence of NEC or feeding intolerance. Furthermore, birth weight seems to be an independent risk factor for the development of NEC, regardless of the timing of MEF introduction.
