International Journal of Contemporary Pediatrics | April 2020 | Vol 7 | Issue 4 Page 932
International Journal of Contemporary Pediatrics
Shanmugam RS et al. Int J Contemp Pediatr. 2020 Apr;7(4):932-937
http://www.ijpediatrics.com pISSN 2349-3283 | eISSN 2349-3291
Original Research Article
Does full enteral feed from day one of life influence weight gain in
hemodynamically stable VLBW babies weighing between 1000-1500
grams as against standard feeding? a randomized controlled trial
Ramya S. Shanmugam*
1
, Mangala Bharathi
2
, Kumutha Jayaraman
3
INTRODUCTION
Preterm neonates post-natal growth should be similar to
the intrauterine growth of the fetus of the same
gestational age.
1
But, most of the preterm very-low-birth
weight infants ended up in a growth-restricted state called
extra uterine growth failure.
2
Introduction of enteral
feeding is delayed in these babies due to the fear of feed
related issues. They enter into a catabolic state, which
results in poor neurodevelopmental outcome. Early
nutrition and neurodevelopment is closely linked. There
is a critical window of opportunity from birth to regain of
birth weight where optimal nutrition has its greatest
benefit.
3
In utero fetus constantly swallows amniotic fluid which
plays an important role in growth and development of GI
tract. Postnatally, enteral feedings also stimulate the
motility of the GI tract and various hormonal secretions.
4-
6
Initiation of early feeding outweigh the issues that can
1
Department of Neonatology, Madras Medical College, Chennai, Tamil Nadu, India
2
Department of Neonatology, IOG, Madras Medical College, Chennai, Tamil Nadu, India
3
Department of Neonatology, Savitha Medical College, Chennai, Tamil Nadu, India
Received: 05 March 2020
Accepted: 09 March 2020
*Correspondence:
Dr. Ramya S. Shanmugam,
E-mail: getniranjan806@yahoo.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background: Preterm neonates post-natal growth should be similar to the intrauterine growth of the fetus of the same
gestational age. This study aims to evaluate the effects of full enteral feed (60 ml/kg/day of human milk on day one,
20ml/kg/day during feeding advancement) started from day one of life (intervention) in enhancing the regain of birth
weight compared to that of standard feed (both human milk feeds and intravenous fluid) in a group.
Methods: Babies were started on enteral feeds with human milk at the rate of 60ml/kg/day from day one and
progressed by increments of 20 ml/kg/day up to maximum enteral feed of 180 ml/kg/day. The primary outcomes like
Number of days taken to regain the birth weight, Duration of hospital stay, Incidence of Necrotising Enterocolitis
(NEC), Incidence of sepsis, need for intravenous fluid therapy was assessed and statically analysed.
Results: Full enteral feeding group infants had lesser days of intravenous fluids. Full enteral feeding group regained
birth weight at a mean age of 17.37±4.9 days and in the standard feeding group, birth weight was regained at a mean
age of 19.8±4.3. Full enteral feeding group regained birth weight at a mean age of 13.12±2.17 days and in standard
feeding group at a mean age of 15.38±3.57and this was statistically significant (p - 0.009). Full enteral feeding group
babies had lesser number of days of intravenous fluids compared to babies in standard feeding group. It was
statistically significant (p - 0.003).
Conclusions: There is lack of awareness regarding dog bite and its management among the rural population.
Keywords: Full feed, Hospital stay, Necrotizing enterocolitis, Preterm, Randomized control trail
DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20201087