Comparison of Volume and Frequency Advancement Feeding Protocols in Very Low Birth Weight Neonates

Overview

Journal Pak J Med Sci

Specialty General Medicine

Date 2018 Apr 13

PMID 29643883

Citations 1

Authors

Afaq Hussain

Abdur Rehman

Nazia Fatima

Affiliations

Soon will be listed here.

Abstract

Objective: To determine the outcomes in very low birth weight (VLBW) neonates receiving volume advancement versus frequency advancement feeding protocols.

Methods: This controlled clinical trial was conducted in Children Hospital Multan within duration of 6 months from February 2017 to August 2017. VLBW neonates having weight < 1500 g at the time of birth were included. The protocol for frequency advancement (FA) group was to give 1 ml/kg human or pre-formula milk after every 8 hours and in volume advancement (VA) group after every 3 hours initially. After three days, in FA group duration of feeds was decreased gradually from 8 to 2 hours and feed volume of 10 ml.kg.day until full-recommended dose of feeding i.e. 150 ml.kg.day reached. While in VA group, volume of 20 ml.kg.day was given until full-recommended dose of feeding reached. Days to achieve full feed, weight gain, and length of hospital stay were primary study outcomes.

Results: Baseline weight of neonates was 1148 (111) grams in VA 1179 (106) grams in FA groups (p-value 0.18). In VA group, full feed was achieved in 11.04 (2.38) days versus 15.76 (2.48) days in FA group (P-value <0.001). Duration of IV fluid therapy were 13.5 (8.4) days in FA group versus 9.4 (7.6) in VA group (p-value <0.001). Moreover weight gain at the end of feeding protocol was significantly higher in VA group 1440 (78) grams versus 1284 (99) grams in FA group (P-value <0.001). Necrotizing entero-colitis occurred in only one neonate that was belonging to volume advancement group.

Conclusion: Volume advancement (VA) feeding is better as compared to frequency advancement (FA) feeding in very low birth weight neonates.

Citing Articles

Short versus long feeding interval for bolus feedings in very preterm infants.

Ibrahim N, Rostenberghe H, Ho J, Nasir A Cochrane Database Syst Rev. 2021; 8:CD012322.

PMID: 34415568 PMC: 8407504. DOI: 10.1002/14651858.CD012322.pub2.

References

Caple J, Armentrout D, Huseby V, Halbardier B, Garcia J, Sparks J . Randomized, controlled trial of slow versus rapid feeding volume advancement in preterm infants. Pediatrics. 2004; 114(6):1597-600. DOI: 10.1542/peds.2004-1232. View

Embleton N . Optimal protein and energy intakes in preterm infants. Early Hum Dev. 2007; 83(12):831-7. DOI: 10.1016/j.earlhumdev.2007.10.001. View

. Breastfeeding and the use of human milk. Pediatrics. 2012; 129(3):e827-41. DOI: 10.1542/peds.2011-3552. View

Franz A, Pohlandt F, Bode H, Mihatsch W, Sander S, Kron M . Intrauterine, early neonatal, and postdischarge growth and neurodevelopmental outcome at 5.4 years in extremely preterm infants after intensive neonatal nutritional support. Pediatrics. 2009; 123(1):e101-9. DOI: 10.1542/peds.2008-1352. View

Lima P, de Carvalho M, Carioca da Costa A, Lopes Moreira M . Variables associated with extra uterine growth restriction in very low birth weight infants. J Pediatr (Rio J). 2013; 90(1):22-7. DOI: 10.1016/j.jped.2013.05.007. View

Horbar J, Ehrenkranz R, Badger G, Edwards E, Morrow K, Soll R . Weight Growth Velocity and Postnatal Growth Failure in Infants 501 to 1500 Grams: 2000-2013. Pediatrics. 2015; 136(1):e84-92. DOI: 10.1542/peds.2015-0129. View

Brown J, Embleton N, Harding J, McGuire W . Multi-nutrient fortification of human milk for preterm infants. Cochrane Database Syst Rev. 2016; (5):CD000343. DOI: 10.1002/14651858.CD000343.pub3. View

Bombell S, McGuire W . Delayed introduction of progressive enteral feeds to prevent necrotising enterocolitis in very low birth weight infants. Cochrane Database Syst Rev. 2008; (2):CD001970. DOI: 10.1002/14651858.CD001970.pub2. View

Morgan J, Young L, McGuire W . Slow advancement of enteral feed volumes to prevent necrotising enterocolitis in very low birth weight infants. Cochrane Database Syst Rev. 2014; (12):CD001241. DOI: 10.1002/14651858.CD001241.pub5. View

10.

Embleton N . Early nutrition and later outcomes in preterm infants. World Rev Nutr Diet. 2013; 106:26-32. DOI: 10.1159/000342553. View

11.

Higgins R, Devaskar S, Hay Jr W, Ehrenkranz R, Greer F, Kennedy K . Executive summary of the workshop "Nutritional Challenges in the High Risk Infant". J Pediatr. 2012; 160(3):511-6. PMC: 4530452. DOI: 10.1016/j.jpeds.2011.12.024. View

12.

Ramel S, Demerath E, Gray H, Younge N, Boys C, Georgieff M . The relationship of poor linear growth velocity with neonatal illness and two-year neurodevelopment in preterm infants. Neonatology. 2012; 102(1):19-24. DOI: 10.1159/000336127. View

13.

Cormack B, Sinn J, Lui K, Tudehope D . Australasian neonatal intensive care enteral nutrition survey: implications for practice. J Paediatr Child Health. 2012; 49(4):E340-7. DOI: 10.1111/jpc.12016. View

14.

Agostoni C, Buonocore G, Carnielli V, de Curtis M, Darmaun D, Decsi T . Enteral nutrient supply for preterm infants: commentary from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2009; 50(1):85-91. DOI: 10.1097/MPG.0b013e3181adaee0. View

15.

Christensen R, Street J . Randomized, controlled trial of slow versus rapid feeding volume advancement in preterm infants. J Pediatr. 2005; 146(5):710-1. DOI: 10.1016/j.jpeds.2005.03.024. View

16.

McGuire W, Henderson G, Fowlie P . Feeding the preterm infant. BMJ. 2004; 329(7476):1227-30. PMC: 529370. DOI: 10.1136/bmj.329.7476.1227. View

17.

Stein A, Barros F, Bhargava S, Hao W, Horta B, Lee N . Birth status, child growth, and adult outcomes in low- and middle-income countries. J Pediatr. 2013; 163(6):1740-1746.e4. PMC: 3849851. DOI: 10.1016/j.jpeds.2013.08.012. View

18.

Neubauer V, Griesmaier E, Pehbock-Walser N, Pupp-Peglow U, Kiechl-Kohlendorfer U . Poor postnatal head growth in very preterm infants is associated with impaired neurodevelopment outcome. Acta Paediatr. 2013; 102(9):883-8. DOI: 10.1111/apa.12319. View

19.

Leppanen M, Lapinleimu H, Lind A, Matomaki J, Lehtonen L, Haataja L . Antenatal and postnatal growth and 5-year cognitive outcome in very preterm infants. Pediatrics. 2013; 133(1):63-70. DOI: 10.1542/peds.2013-1187. View

20.

Culpepper C, Hendrickson K, Marshall S, Benes J, Grover T . Implementation of Feeding Guidelines Hastens the Time to Initiation of Enteral Feeds and Improves Growth Velocity in Very Low Birth-Weight Infants. Adv Neonatal Care. 2016; 17(2):139-145. DOI: 10.1097/ANC.0000000000000347. View