Safety of Initiating Early Enteral Feeding with Slow Volume Advancement in Preterm Infants
Kriangsak Jirapaet MD, MPH*, Veena Jirapaet RN, PhD**, Suthida Sritipsukho MD***
Affiliation : * Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand *** Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Objective : To determine the safety of enteral feeding within 24 hours of life with slow volume increase on the incidence of
necrotizing enterocolitis (NEC) and late-onset sepsis (LOS).
Results : Prospective descriptive study.
Material and Method: Between January 1998 and December 2001, 117 preterm infants with birth weight < 1,750 g were
recruited prospectively, 102 in the human-milk-fed group (HMG) and 15 in the formula-fed group (FG). Feeds were
advanced by increments of 10 mL/kg/d, aimed at 150 mL/kg/d in 15 days. Charts of 146 preterm infants admitted during
1996-1997 were reviewed for pre-study incidences of NEC and LOS.
Results : NEC developed 3.92% in HMG and 20% in FG (p =.044). LOS developed 2.94% in HMG and 13.33% in FG
(p = 0.122). The overall incidence of NEC was almost similar (5.98% vs. 6.16%) while that of LOS was lower (4.27% vs.
12.32%) when compared to the pre-study incidences.
Conclusion : The present study provides a practice that seems to reduce LOS risk without increasing NEC risk and confirms
the protective effect of human milk against NEC.
Keywords : Human milk, Early feeding, Slow volume advancement, Necrotizing enterocolitis, Preterm infant, Late-onset sepsis
