Early enteral feeding of the preterm infant

Abstract

Recently published randomised controlled trials provide no evidence to support the practice of postponing enteral feeding to reduce the incidence of NEC. On the contrary, feeding within the first few days of life yields demonstrable benefits such as reduced incidence of sepsis and earlier discharge from hospital. Although manometry suggests that slow infusion of feeds is associated with improved gastric emptying, clinical trials suggest that 'bolus' three hourly feeding is if anything less likely to result in feed intolerance than continuous infusion. Use of human milk reduces the risk of NEC and infection irrespective of other feeding interventions, although routine 'fortification' may prejudice this while offering no proven long term growth or developmental advantage.