Publication:

Does full enteral feed from day one of life influence weight gain in hemodynamically stable VLBW babies weighing between 1000-1500 grams as against standard feeding? an open label randomized controlled trial

Background Preterm neonates post-natal growth should be similar to the intrauterine growth of the fetus of the same gestational age. This study aims to  evaluate the effects of full enteral feed (60 ml/kg/day of human milk on day one, 20ml/kg/day during feeding advancement) started from day one of life (intervention) in enhancing   the regain of birth weight compared to that of standard feed (both human milk feeds and intravenous fluid) in a group.

Methods Babies were started on enteral feeds with human milk at the rate of 60ml/kg/day from day one and progressed by increments of 20 ml/kg/day up to maximum enteral feed of 180 ml/kg/day. The primary outcomes like Number of days taken to regain the birth weight, Duration of hospital stay, Incidence of Necrotising Enterocolitis (NEC), Incidence of sepsis, need for intravenous fluid therapy was assessed and statically analysed.

Results Full enteral feeding group infants had lesser days of intravenous fluids. Full enteral feeding group regained birth weight at a mean age of 17.37±4.9 days and in the standard feeding group, birth weight was regained at a mean age of 19.8±4.3. Full enteral feeding group regained birth weight at a mean age of 13.12±2.17 days and in standard feeding group at a mean age of 15.38±3.57and this was statistically significant (p - 0.009). Full enteral feeding group babies had lesser number of days of intravenous fluids compared to babies in standard feeding group. It was statistically significant (p - 0.003).

Conclusions Full enteral feeding practices from day one of life with human milk is feasible, cost effective and safe in hemodynamically stable VLBW infants and results in earlier regain of birth weight