Enteral Feeding as an Adjunct to Hypothermia in Neonates with Hypoxic-Ischemic Encephalopathy

Neonatology. 2018;113(4):347-352. doi: 10.1159/000487848. Epub 2018 Mar 6.


Background: Withholding enteral feedings during hypothermia lacks supporting evidence.

Objectives: We aimed to determine if minimal enteral nutrition (MEN) during hypothermia in patients with hypoxic-ischemic encephalopathy was associated with a reduced duration of parenteral nutrition, time to full oral feeds, and length of stay, but would not be associated with increased systemic inflammation or feeding complications.

Methods: We performed a pilot, retrospective, matched case-control study within the Florida Neonatal Neurologic Network from December 2012 to May 2016 of patients who received MEN during hypothermia (n = 17) versus those who were not fed (n = 17). Length of stay, feeding-related outcomes, and brain injury identified by MRI were compared. Serum inflammatory mediators were measured at 0-6, 24, and 96 h of life by multiplex assay. MRI were scored using the Barkovich system.

Results: MEN subjects had a reduced length of hospital stay (mean 15 ± 11 vs. 24 ± 19 days, p < 0.05), days receiving parenteral nutrition (7 ± 2 vs. 11 ± 6, p < 0.05), and time to full oral feeds (8 ± 5 vs. 18 ± 18, p < 0.05). MEN was associated with a significantly reduced serum IL-12p70 at 24 and 96 h (p < 0.05). Brain MRI scores were not significantly different between groups.

Conclusion: MEN during hypothermia was associated with a reduced length of stay and time to full feeds, but did not increase feeding complications or systemic inflammation.

Keywords: Feeding; Hypothermia; Inflammation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Enteral Nutrition*
  • Female
  • Florida
  • Humans
  • Hypothermia, Induced*
  • Hypoxia-Ischemia, Brain / therapy*
  • Infant, Newborn
  • Infant, Premature
  • Interleukin-12 / blood*
  • Length of Stay
  • Magnetic Resonance Imaging
  • Male
  • Parenteral Nutrition
  • Pilot Projects
  • Retrospective Studies


  • Interleukin-12