EARLY ENTERAL FEEDING AND LATER CLINICAL OUTCOMES IN VLBW INFANTS: A RETROSPECTIVE, 8-YEAR COHORT STUDY

BACKGROUND: Early enteral feeding (any enteral milk feed in the first few days of life in subnutritional quantities (5-10 ml/Kg/day on the 1st day) can promote gut development, enhance feeding tolerance with more precocious weight gain. OBJECTIVE: To examine the role of early enteral feeding on later clinical outcomes in VLBW infants (n° of days to reach full enteral feeding, weight and GA at discharge, duration of hospital stay). DESIGN/METHODS: A retrospective study was conducted by review of VLBW infants charts, from Jan 2000 to June 2008. Data collected: day of life when enteral intake was started and when infants reached full enteral feedings (90% of Kcal per os), infant weight and GA at discharge, length of neonatal hospital stay. Our nutritional policy: administration of fresh, expressed maternal milk, whenever possible, or preterm formula when needed. RESULTS: Charts of 316 VLBW infants (males 157, SGA 118, BW 1181±124g, GA 30±3wks) were reviewed and analysed. Relationship among starting of enteral nutrition, full enteral feeding and hospital stay was explored. The standard correlation matrix (Bravais-Pearson coefficients in the intersections) among the main variables of the dataset confirmed a strong and well-known correlation among full enteral feeding, birth GA, PN and hospital stay. Standard ANOVA regression tests exclude independence for each pairs of variables. Removing the influence of birth GA, the matrix showed significant and direct correlations among starting of enteral, full enteral and hospital stay. According to Ordinary Least Square model (R2 = 0,725), starting enteral nutrition 1 day before reduces hospital stay of 2 days. CONCLUSIONS: Early enteral feeding in VLBW infants produces a rapid regain of initial weight loss, improves weight gain and enhances earlier achievement of full enteral feedings allowing a precocious discharge from hospital. E-PAS2009:5502.28