Slow versus rapid enteral feeding advancement in preterm newborn infants 1000-1499 g: a randomized controlled trial

Acta Paediatr. 2010 Jan;99(1):42-6. doi: 10.1111/j.1651-2227.2009.01519.x.


Aim: To evaluate whether preterm neonates weighing 1000-1499 g at birth receiving rapid enteral feeding advancement at 30 mL/kg/day attain full feedings (180 mL/kg/day) earlier than those receiving slow enteral feeding advancement at 20 mL/kg/day without increase in the incidence of feeding intolerance or necrotizing enterocolitis.

Methods: A total of 100 stable intramural neonates weighing between 1000 and 1499 g and gestational age less than 34 weeks were randomly allocated to enteral feeding (expressed human milk or formula) advancement of 20 mL/kg/day (n = 50) or 30 mL/kg/day (n = 50).

Results: Neonates in the rapid feeding advancement group achieved full volume feedings before the slow advancement group (median 7 days vs. 9 days) (p < 0.001), had significantly fewer days of intravenous fluids (median 2 days vs. 3.4 days) (p < 0.001), shorter length of stay in hospital (median 9.5 days vs. 11 days) (p = 0.003) and regained birth weight earlier (median 16 days vs. 22 days) (p < 0.001). There were no statistical differences in the proportion of infants with apnea, feed interruption or feed intolerance.

Conclusion: Rapid enteral feeding advancements of 30 mL/kg/day are well tolerated by stable preterm neonates weighing 1000-1499 g.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Chi-Square Distribution
  • Enteral Nutrition / adverse effects
  • Enteral Nutrition / methods*
  • Enterocolitis, Necrotizing / etiology
  • Female
  • Humans
  • Infant Formula / statistics & numerical data
  • Infant Nutritional Physiological Phenomena*
  • Infant, Newborn
  • Infant, Premature / physiology*
  • Infant, Very Low Birth Weight / physiology*
  • Length of Stay
  • Male
  • Milk, Human
  • Statistics, Nonparametric
  • Time Factors
  • Treatment Outcome