Earlier achievement of full enteral feeding in extremely low birth weight neonates is not associated with growth improvement in the first 2 years of life

Abstract

Limiting the number of days until achievement of full enteral feeding in extremely low birth weight neonates (ELBW; < 1000 g) might affect growth in the first years of life. This study compared the Z scores in growth over time of two cohorts of ELBW neonates that were comparable on maternal and neonatal characteristics and characteristics of hospitalization, but differed in enteral feeding strategy during neonatal admission. In the 2010–2014 cohort, full enteral feeding was achieved on average 16 days earlier than in the 2000–2005 cohort. In both cohorts, weight, height, and head circumference were recorded at birth and at the corrected ages of 9 and 24 months. A linear mixed model with repeated measures controlling for neonates small for gestational age showed no significant effect of different strategies in achievement of full enteral feeding on any anthropometric Z scores over time. Although full enteral feeding was achieved earlier in the 2010–2014 cohort, this was not associated with growth patterns during the first two years of life. Conclusion: The effect of a change in strategy to achieve full enteral feeding at an earlier stage in ELBW neonates was assessed. Early enteral feeding strategies do not necessarily improve growth during the first two years of life.What is Known:• Feeding strategies during neonatal stay may affect growth in the first years of life.• Strategies to achieve full enteral feeding earlier were implemented, but data on the impact on subsequent growth after discharge are limited.What is New:• Full enteral feeding was achieved earlier, but this was not associated with improved growth during the first 2 years of life after discharge.• Early enteral feeding strategies do not necessarily improve growth during the first 2 years of life.