Enteral Feeding and Necrotizing Enterocolitis: Does Time of First Feeds and Rate of Advancement Matter?

Masoli L, Daniela; Domínguez, Angélica; Tapia, José L; Uauy, Ricardo; Fabres, Jorge; NEOCOSUR neonatal network

Keywords: enteral nutrition, feeding practices, premature infant, very-low-birth-weight infant

Abstract

Objective: The aim of the study was to determine if time to initial enteral feeding (EF) and rate of advancement are associated with necrotizing enterocolitis (NEC) or death. Methods: Secondary analysis of prospectively collected data of very-low-birth-weight infants (VLBWI: 400--1500 g) born in 26 NEOCOSUR centers between 2000 and 2014. Results: Among 12,387 VLBWI, 83.7% survived without NEC, 6.6% developed NEC and survived, and 9.6% had NEC and died or died without NEC (NEC/death). After risk adjustment, time to initial EF (median = 2 days) was not associated with NEC; however, delaying it was protective for NEC/death (odds ratio [OR] = 0.96; 95% confidence interval [CI] 0.93--0.99). A slower feeding advancement rate (FAR) was protective for NEC (OR = 0.97; 95% CI = 0.94–0.98) and for NEC/death (OR = 0.98; 95% CI = 0.96–0.99). Conclusions: In VLBWI, there was no association between an early initial EF and NEC, although delaying it was associated with less NEC/death. A slower FAR was associated with lower risk of both outcomes.

Más información

Título de la Revista: JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION
Volumen: 72
Editorial: LIPPINCOTT WILLIAMS & WILKINS
Fecha de publicación: 2021
Página de inicio: 763
Página final: 768
Idioma: Inglés
URL: https://journals.lww.com/jpgn/Fulltext/2021/05000/Enteral_Feeding_and_Necrotizing_Enterocolitis_.28.aspx#
DOI:

doi: 10.1097/MPG.0000000000003069