Early feeding advancement in very low-birth-weight infants with intrauterine growth retardation and increased umbilical artery resistance

J Pediatr Gastroenterol Nutr. 2002 Aug;35(2):144-8. doi: 10.1097/00005176-200208000-00008.


Background: To investigate whether intrauterine growth retardation (birth weight <10th percentile), increased umbilical artery resistance (resistance index >90th percentile measured by Doppler velocimetry), or brain sparing (increased umbilical artery resistance and decreased middle cerebral artery resistance index <5th percentile) were associated with early feeding intolerance in very low-birth-weight (VLBW, <1,500 g) infants.

Methods: From July 1999 to December 2000, 124 inborn VLBW infants were enrolled in a prospective trial evaluating early enteral nutrition after a standardized feeding protocol (daily feeding advancement, 16 mL/kg birth weight). Feeding tolerance was assessed as the age at which full enteral feeds (150 mL/kg daily) were achieved. Data are shown as median, 25th, and 75th percentiles.

Results: Full enteral feeds were achieved at 15 days (range, 12-21 days) of age for all infants. Intrauterine growth retardation (full enteral feeding achieved at 14 days; range, 12-21 days), increased umbilical artery resistance (full enteral feeding achieved at 14 days; range, 11-16 days), and brain sparing (full enteral feeding achieved at 15 days; range, 14-20 days) were not associated with early feeding intolerance.

Conclusion: Very low-birth-weight infants with intrauterine growth retardation, increased umbilical artery resistance, and brain sparing tolerated enteral feeding as well as appropriate-for-gestational-age VLBW infants.

MeSH terms

  • Cerebral Arteries / physiology
  • Enteral Nutrition* / adverse effects
  • Female
  • Fetal Growth Retardation* / physiopathology
  • Humans
  • Infant Food
  • Infant Nutritional Physiological Phenomena*
  • Infant, Newborn
  • Infant, Very Low Birth Weight / physiology*
  • Laser-Doppler Flowmetry / methods
  • Male
  • Prospective Studies
  • Time Factors
  • Umbilical Arteries / physiology*
  • Vascular Resistance