Original Articles
Time to Attain Full Enteral Feeding and Its Predictors among Very Low Birth Weight (VLBW) Neonates Admitted to the Neonatal Intensive Care Unit: Experience of a Tertiary Care Centre | |
Dr. Samiksha Sharma, Dr. Khodaija Mahvish, Dr. Girijanand Jha, Dr (Prof) Alka Singh, Dr (Prof) Binod Kumar Singh | |
Background and Objectives: Full enteral feeding (FEF) is defined as the time when newborn infants receive all of their prescribed nutrition (120–150 ml/kg/day) as milk feeds (human milk or formula) and do not receive any supplemental parenteral fluids or nutrition after birth. Based on the available experience, expected time to achieve FEF is 7 days for infants born 1–1.5 kg and 14 days for infants born < 1 kg. Early introduction of enteral feeds and rapid achievement of FEF are the cornerstone of nutritional management of VLBW neonates to reduce the need for central venous catheters, risk of infection, liver problems, persistent gut immaturity and duration of hospital stay. The present study was conducted to study the time to attain full enteral feeds (FEF) and its predictors among VLBW neonates admitted to the NICU of our hospital. Methods: This hospital based prospective observational study was conducted over a period of 2 years from January 2020 to December 2021 at NICU of department of Pediatrics of N.M.C.H, Patna including consecutively admitted preterm neonates of birth weight 1000 gram to <1500 gram with age less than 24 hours at our NICU. Result: Over the two years study period, 191 neonates were studied. Mean weight of the study population was 1.261± 134 grams and mean gestational age was 32+3 ± 1+5 weeks. First feeds were started before 24 hours in 36 (18.8%), between 24-48 hours in 42 (22%), between 72 hours in 61 (31.9%) and after 72 hours in the rest 52 (27.2%) neonates. Only 44 (23%) neonates could be started on expressed breast milk (EBM) exclusively and the rest needed preterm formula milk. Median time to achieve FEF among neonates with GA 32–37 weeks was 11 days (IQR of 10–12 days), which was significantly shorter as compared to those with <32 weeks of GA (median 14 days; IQR: 12–15). Median time of EFF among neonates without NEC was 9 days (IQR of 8–10 days), which was significantly shorter as compared to those with NEC (median 14 days; IQR: 13–15). Similarly, the median time of full enteral feeding among VLBW neonates who were fed formula milk was 12 days (IQR of 11–12 days), which was significantly longer as compared to those who were fed with expressed breast milk (median 9 days; IQR: 9–10). Conclusion: Necrotizing enterocolitis, GA at birth, type of enteral feeds and birth outcome were significantly associated with time to FEF among VLBW neonates admitted to our NICU. |
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