Randomized trial of "slow" versus "fast" feed advancements on the incidence of necrotizing enterocolitis in very low birth weight infants.

Academic Article


  • OBJECTIVE: To determine whether the rate of feed advancement affects the incidence of necrotizing enterocolitis (NEC). STUDY DESIGN: Prospective randomized controlled trial involving 185 formula-fed infants with birth weight 501 to 1500 g and gestational age /=II) was similar in both groups (slow 13% and fast 9%, P =.5). The incidence of perforation (Bell stage III) was also similar in both groups (slow 4% and fast 2%, P =.8). Feeds were started at a comparable postnatal age in both groups (median age: slow 5 days and fast 4 days, P =.9). Although the neonates in the fast group attained full enteral intake earlier (median days [25th and 75th percentiles]: slow 15 [12, 21] and fast 11 [8, 15], P <.001) and regained their birth weight earlier (slow 15 [11, 20] and fast 12 [8, 15], P <.05), their ages at discharge were not statistically different (slow 47 [31, 67] and fast 43 [29, 62], P =.3) CONCLUSIONS: A greater than twofold difference in the rate of feed advancement from 15 cc/kg/d to 35 cc/kg/d did not affect the incidence of NEC >/= stage II. Factors other than feed advancement appear to be more important in the pathogenesis or progression of NEC.
  • Published In


  • Age Distribution, Chi-Square Distribution, Enteral Nutrition, Enterocolitis, Necrotizing, Humans, Incidence, Infant, Newborn, Infant, Very Low Birth Weight, Prospective Studies, Statistics, Nonparametric, Time Factors
  • Author List

  • Rayyis SF; Ambalavanan N; Wright L; Carlo WA
  • Start Page

  • 293
  • End Page

  • 297
  • Volume

  • 134
  • Issue

  • 3