Effect of different positions on gastric residuals in preterm infants initiating full enteral feeding

Objectives: To evaluate the relationship between gastric emptying (GE) time and days to achievement of full enteral feeding (≥140 mL/kg/day) in preterm infants randomly assigned to receive one of two marketed study formulas for the first 14 feeding days: intact protein premature formula (IPF) or extensively hydrolyzed protein (EHF) formula. Methods: In this triple-blind, controlled, prospective, clinical trial, we report GE time (time to half-emptying, t1/2) by real-time ultrasonography on Study Day 14, in preterm infants receiving IPF or EHF formula. The association between GE time and achievement of full enteral feeding was evaluated by Pearson correlation. Per-protocol populations for analysis included participants who (1) completed the study (overall) and (2) who received ≥ 75% study formula intake (mL/kg/day). Results: Median GE time at Day 14 was significantly faster for the EHF vs. IPF group overall and in participants who received ≥ 75% study formula intake (p ≤ 0.018). However, we demonstrated GE time had no correlation with the achievement of full enteral feeding (r = 0.08; p = 0.547). Conclusion: Feeding IP premature formula vs. EH formula was associated with shorter time to full enteral feeding. However, faster GE time did not predict feeding success and may not be a clinically relevant surrogate for assessing feeding tolerance.

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Does selective evaluation of gastric aspirates in preterm infants influence time to full enteral feeding?

Journal of Paediatrics and Child Health ◽

10.1111/jpc.14993 ◽

2020 ◽

Vol 56 (7) ◽

pp. 1150-1154

Author(s):

Lydia Kennedy ◽

Thomas Rogerson ◽

Amy Kate Keir

Keyword(s):

Preterm Infants ◽

Enteral Feeding ◽

Full Enteral Feeding

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The Impact of Routine Evaluation of Gastric Residual Volumes on the Time to Achieve Full Enteral Feeding in Preterm Infants

The Journal of Pediatrics ◽

10.1016/j.jpeds.2017.05.054 ◽

2017 ◽

Vol 189 ◽

pp. 128-134 ◽

Cited By ~ 16

Author(s):

Arieh Riskin ◽

Keren Cohen ◽

Amir Kugelman ◽

Arina Toropine ◽

Waseem Said ◽

...

Keyword(s):

Preterm Infants ◽

Enteral Feeding ◽

The Impact ◽

Full Enteral Feeding

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Oropharyngeal Administration of Colostrum for Preventing Necrotizing Enterocolitis and Late-onset Sepsis in Preterm Infants with Gestational Age ≤ 32 Weeks: A Single-center Randomized Controlled Trial

10.21203/rs.3.rs-145820/v1 ◽

2021 ◽

Author(s):

xia ouyang ◽

changyi yang ◽

wenlong xiu ◽

yanhua hu ◽

susu mei ◽

...

Keyword(s):

Preterm Infants ◽

Necrotizing Enterocolitis ◽

Enteral Feeding ◽

Gestational Age ◽

Late Onset ◽

Controlled Trial ◽

Control Group ◽

Clinical Trial Registry ◽

Late Onset Sepsis ◽

Full Enteral Feeding

Abstract BackgroundOropharyngeal administration of colostrum (OAC) may provide immunoprotective and anti-inflammatory effects that potentially reduce the incidence of necrotizing enterocolitis (NEC) and late-onset sepsis (LOS) and improve short-term outcomes.ObjectiveTo evaluate the role of OAC in the early prevention of NEC and LOS in preterm infants with gestational age (GA) ≤ 32 weeks.MethodsA randomized, placebo-controlled trial was conducted in a 40-bed tertiary neonatal intensive care unit (NICU) in China. Preterm infants with GA ≤ 32 weeks were divided randomly into an OAC group, which received 0.4 ml maternal colostrum smearing via the oropharyngeal route every 3 hours for 10 days beginning within the first 48 hours after birth, and a control group, which received normal saline instead. Data from the two groups were collected and compared.ResultsA total of 127 patients in the OAC group and 125 patients in the control group were finally enrolled. The incidence of NEC (Bell stage 2 or 3) and LOS was lower in the OAC group [2.4% vs. 10.4%, χ2 = 6.845, ༰=0.009; 4.7% vs. 13.6%, χ2 = 5.983, ༰=0.014]. In addition, the incidence of intraventricular hemorrhage (IVH) (stage 3 or 4) was lower [1.6% vs. 7.2%,χ2 = 4.775, ༰=0.029], and the time of achieving full enteral feeding was shorter [ 22.0 days vs. 25.0 days༌Z = 6༌424.500༌P = 0.009)] in the OAC group. No cases of adverse reactions were observed in either group.ConclusionsOAC is a safe and simple NICU procedure that yields a potential advantage in decreasing the incidence of NEC, LOS, and severe IVH and shortening the time to achieve full enteral feeding in preterm infants with GA ≤ 32 weeks.Trial registrationChinese Clinical Trial Registry, ChiCTR1900023697, Registered 8 June 2019, Retrospectively registered, http://www.chictr.org.cn/edit.aspx? pid = 39398

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Nasogastric versus Orogastric Bolus Tube Feeding in Preterm Infants: Pilot Randomized Clinical Trial

American Journal of Perinatology ◽

10.1055/s-0040-1713865 ◽

2020 ◽

Author(s):

Ahmed Tawfik Badran ◽

Menna Hashish ◽

Alaa Ali ◽

Mohamed Shokeir ◽

Abd Shabaan

Keyword(s):

Clinical Trial ◽

Preterm Infants ◽

Enteral Feeding ◽

Nasogastric Tube ◽

Tube Feeding ◽

Feeding Tube ◽

Incidence Rates ◽

Orogastric Tube ◽

Nasogastric Tube Feeding ◽

Full Enteral Feeding

Objective According to the most recent metanalysis, the best way to establish safe enteral feeding in preterm babies using nasogastric or orogastric tubes is still not well understood. This study aimed to determine the effects of bolus nasal tubes versus bolus orogastric tubes on the time required to reach full enteral feeding in preterm infants, as well as to compare the incidence rates of adverse events including nonintentional removal or displacement of the feeding tube, aspiration pneumonia/pneumonitis, apnea, necrotizing enterocolitis, gastric residual, and growth parameters between the studied cohort of preterm infants. Study Design We conducted an unblinded pilot randomized clinical trial on hemodynamically stable preterm infants (>28 weeks) recruited from level 2 neonatal intensive care unit at Mansoura University Children's Hospital from June 2015 to May 2017. Results Our study included 98 stable preterm infants with mean gestational age (orogastric group: 33.27 ± 1.08, nasogastric group: 33.32 ± 1.57) and mean birthweight (orogastric group: 1,753.3 ± 414.51, nasogastric group: 1,859.6 ± 307.05). Preterm infants who were fed via bolus nasogastric tube achieved full enteral feeding in a significantly shorter duration compared with the infants fed via bolus orogastric tube. The incidence rates of aspiration and feeding tube displacement were significantly higher in the bolus orogastric tube group compared with the bolus nasogastric tube group. There was no difference in the incidence rates of apnea, necrotizing enterocolitis, bradycardia, oxygen desaturation, and gastric residual in both groups. Conclusion Preterm infants without any respiratory support receiving bolus nasogastric tube feeding achieved full enteral feeding significantly sooner than those receiving bolus orogastric tube feeding. Additionally, bolus nasogastric tube feeding had a lower incidence of aspiration, tube displacement, and the infants regained birthweight more quickly than those receiving orogastric tube feeding. Key Points

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Shorter Time to Full Preterm Feeding Using Intact Protein Formula: A Randomized Controlled Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16162911 ◽

2019 ◽

Vol 16 (16) ◽

pp. 2911 ◽

Cited By ~ 2

Author(s):

Maria Elisabetta Baldassarre ◽

Antonio Di Mauro ◽

Margherita Fanelli ◽

Manuela Capozza ◽

Jennifer L. Wampler ◽

...

Keyword(s):

Breast Milk ◽

Preterm Infants ◽

Enteral Feeding ◽

Primary Outcome ◽

Controlled Trial ◽

Intact Protein ◽

Group Differences ◽

Preterm Formula ◽

Hydrolyzed Formula ◽

Full Enteral Feeding

Background: This study was carried out to evaluate enteral feeding advancement and tolerance in preterm infants receiving one of two marketed formulas: intact protein preterm formula (IPF) or extensively hydrolyzed formula (EHF) for the first 14 feeding days. Methods: Primary outcome was days to full enteral feeding (≥140 mL/kg/day). Per protocol analyses included the following: all participants who met study entrance criteria and completed study feeding (primary) and those who received ≥75% enteral intake from study formula (subset). Mothers were encouraged to provide their breast milk. Results: Of the 65 enrolled (IPF: n = 32; EHF: n = 33), 60 completed study feeding per protocol (IPF: n = 30; EHF: n = 30), 37 (62%) received predominantly breast milk, and 23 (38%) received ≥75% study formula intake (IPF: n = 11; EHF: n = 12). No group differences were detected in tolerance measures. No necrotizing enterocolitis (NEC) was reported. Median time to achievement of full enteral feeding was significantly shorter for the IPF vs. EHF group (day 10 vs. 14, p < 0.05) (subset analysis). Mean enteral intake significantly increased by day 14 for the IPF group (p < 0.05), reflecting group divergence as achieved feeding volumes increased. Conclusions: Results suggest shorter time to full enteral feeding and higher feeding volume achieved by study end in preterm infants receiving intact protein preterm formula versus extensively hydrolyzed formula.

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Short versus Extended Duration of Trophic Feeding to Reduce Time to Achieve Full Enteral Feeding in Extremely Preterm Infants: An Observational Study

Neonatology ◽

10.1159/000472247 ◽

2017 ◽

Vol 112 (3) ◽

pp. 211-216 ◽

Cited By ~ 2

Author(s):

Ariel A. Salas ◽

Nazia Kabani ◽

Colm P. Travers ◽

Vivien Phillips ◽

Namasivayam Ambalavanan ◽

...

Keyword(s):

Observational Study ◽

Preterm Infants ◽

Enteral Feeding ◽

Extremely Preterm ◽

Extremely Preterm Infants ◽

Extended Duration ◽

Full Enteral Feeding ◽

Trophic Feeding

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Efficacy of oral erythromycin to enhance feeding tolerance in preterm infants

Paediatrica Indonesiana ◽

10.14238/pi57.3.2017.154-9 ◽

2017 ◽

Vol 57 (3) ◽

pp. 154

Author(s):

Made Sukmawati ◽

Rinawati Rohsiswatmo ◽

Rulina Suradi ◽

Pramita Gayatri

Keyword(s):

Placebo Group ◽

Hospital Stay ◽

Preterm Infants ◽

Enteral Feeding ◽

Controlled Trial ◽

Length Of Hospital Stay ◽

Feeding Intolerance ◽

Body Weights ◽

Full Enteral Feeding ◽

Feeding Tolerance

Background Feeding intolerance is a common condition that affects preterm infants. Erythromycin is a prokinetic agent used to treat feeding intolerance, but its efficacy remains inconclusive.Objective To evaluate the effectiveness of oral erythromycin to enhance feeding tolerance in preterm infants.Methods This prospective, randomized controlled trial in preterm infants was conducted at Sanglah Hospital, Denpasar, Bali, from June 2015 to January 2016. Eligible infants were randomized to receive either 12.5 mg/kg/dose oral erythromycin or a placebo, every 8 hours. The primary outcome was the time to establish full enteral feeding. The secondary outcomes were body weight at full enteral feeding and length of hospital stay.Results Of 62 initial subjects, 3 infants dropped out of the study. Thirty infants were given erythromycin and 29 infants were given placebo. The baseline characteristics of the two groups were similar, with mean of gestational ages of 31.4 (SD 1.7) weeks in the erythromycin group and 32.4 (SD 2.2) weeks in the placebo group. The median times to reach full enteral feeding did not significantly differ between the two groups, with 10 (SD 5.3) days in the erythromycin group vs. 8 (SD 6.5) days in the placebo group (P=0.345). Also, median body weights at full enteral feeding and lengths of hospital stay were not significantly different between the two groups.Conclusion Erythromycin of 12.5 mg/kg/dose every 8 hours as prophylactic treatment does not significantly enhance feeding tolerance in preterm infants. Median body weights at full enteral feeding and length of hospital stay are not significantly different between the erythromycin and placebo groups.

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