ABSTRACT
Objective: To determine the outcomes in very low birth weight [VLBW] neonates receiving volume advancement versus frequency advancement feeding protocols
Methods: This controlled clinical trial was conducted in Children Hospital Multan within duration of 6 months from February 2017 to August 2017. VLBW neonates having weight < 1500 g at the time of birth were included. The protocol for frequency advancement [FA] group was to give 1 ml/kg human or preformula milk after every 8 hours and in volume advancement [VA] group after every 3 hours initially. After three days, in FA group duration of feeds was decreased gradually from 8 to 2 hours and feed volume of 10 ml.kg-1.day-1 until full-recommended dose of feeding i.e. 150 ml.kg-1.day-1 reached. While in VA group, volume of 20 ml.kg-1.day-1 was given until full-recommended dose of feeding reached. Days to achieve full feed, weight gain, and length of hospital stay were primary study outcomes
Results: Baseline weight of neonates was 1148 [111] grams in VA 1179 [106] grams in FA groups [p-value 0.18]. In VA group, full feed was achieved in 11.04 [2.38] days versus 15.76 [2.48] days in FA group [P-value <0.001]. Duration of IV fluid therapy were 13.5 [8.4] days in FA group versus 9.4 [7.6] in VA group [p-value <0.001]. Moreover weight gain at the end of feeding protocol was significantly higher in VA group 1440 [78] grams versus 1284 [99] grams in FA group [P-value <0.001]. Necrotizing entero-colitis occurred in only one neonate that was belonging to volume advancement group
Conclusion: Volume advancement [VA] feeding is better as compared to frequency advancement [FA] feeding in very low birth weight neonates