1394 Weight Gain in Babies of 28-32 Weeks Gestational Age; Impact of a Standardised Enteral Feeding Regime

Abstract

Background and Aims Earlier studies have shown that optimal early neonatal growth improves neurodevelopmental outcomes in preterm infants. A standardised enteral feeding regime (SEFR) was introduced across a UK neonatal network in April 2011. Effects of this standardisation on early neonatal growth are examined in our observational study. Methods We retrospectively compared two cohorts of babies born in our unit at 28-31+6 weeks gestation during two epochs, one before and one after implementation of SEFR. Epoch1 extended between April and December 2010, Epoch2 between April and December 2011. Patients who were transferred in or out of the unit for continuation of care were excluded. Results 20 patients were included in Epoch1(E1), 16 in Epoch2(E2). Baseline characteristics (gestation, birth weight, neonatal care) were similar between groups. E1 cohort regained birth weight in 11.65(6-17) days, reaching full enteral feeds at 7.3(2-18) days. E2 cohort regained birth weight in 11.06(5-18) days and reached full feeds at 7.88(5-15) days. TPN was used in 65%(n=13/20) of E1 cohort for 6.7(1-12) days and in 87.5%(n=14/16) of E2 cohort for 6.3(2-11) days. Average weight gain was 14.5g/kg/day for E1 and 17.8g/kg/day for E2 cohort (p<0.05). No patients in either epoch had necrotising enterocolitis. Conclusions We demonstrate that feeding regime standardisation results in better early weight gain. The latter has been associated with improved long-term motor and cognitive development, as shown by Franz et al in 2009. Our sample size prohibits further conclusions. More studies including larger numbers are warranted.