Guidelines for feeding very low birth weight infants

Nutrients. 2015 Jan 8;7(1):423-42. doi: 10.3390/nu7010423.


Despite the fact that feeding a very low birth weight (VLBW) neonate is a fundamental and inevitable part of its management, this is a field which is beset with controversies. Optimal nutrition improves growth and neurological outcomes, and reduces the incidence of sepsis and possibly even retinopathy of prematurity. There is a great deal of heterogeneity of practice among neonatologists and pediatricians regarding feeding VLBW infants. A working group on feeding guidelines for VLBW infants was constituted in McMaster University, Canada. The group listed a number of important questions that had to be answered with respect to feeding VLBW infants, systematically reviewed the literature, critically appraised the level of evidence, and generated a comprehensive set of guidelines. These guidelines form the basis of this state-of-art review. The review touches upon trophic feeding, nutritional feeding, fortification, feeding in special circumstances, assessment of feed tolerance, and management of gastric residuals, gastro-esophageal reflux, and glycerin enemas.

Publication types

  • Review

MeSH terms

  • Breast Feeding
  • Canada
  • Enema
  • Enteral Nutrition / methods
  • Enteral Nutrition / standards*
  • Fetal Blood / metabolism
  • Food, Fortified
  • Gastroesophageal Reflux / diet therapy
  • Gastroesophageal Reflux / drug therapy
  • Glycerol / administration & dosage
  • Humans
  • Hypotension / diet therapy
  • Ibuprofen / administration & dosage
  • Indomethacin / administration & dosage
  • Infant, Newborn
  • Infant, Premature / growth & development
  • Infant, Very Low Birth Weight / growth & development*
  • Meta-Analysis as Topic
  • Milk, Human
  • Nutrition Policy*
  • Nutritional Status
  • Randomized Controlled Trials as Topic
  • Ventilation


  • Glycerol
  • Ibuprofen
  • Indomethacin