The Effect of Early Enteral Trophic Feeding within 24 Hours after Birth in Extremely Low Birth Weight Infants of 26 Weeks and Less, and Birth Weight below 1,000 g

ABSTRACT

PURPOSE: To investigate the effect of early enteral trophic feeding within 24 hours after birth compared with being started within 7 days after birth in extremely low birth weight infants (ELBWIs). METHODS: We retrospectively analyzed the medical records of all ELBWIs with gestational age of 26 weeks and less, and birth weight below 1,000 g, admitted within 24 hours after birth to neonatal intensive care unit of Samsung Medical Center from January 2000 to June 2006 who were alive at the time of discharge. Data for nutritional status and morbidities were compared between Era 1 (n=76), in which early enteral trophic feeding was started within 7 days after birth and Era 2 (n=46), started within 24 hours after birth. RESULTS: Compared to era 1, despite that gestational age and enteral feeding strarting time of ELBWIs was significantly earlier (25(+4)+/-0(+6) vs. 24(+6)+/-1(+5) weeks, 4.5+/-5.1 vs. 0.7+/-1.3 days), the time to achieve full enteral feeding was significantly shorter, and the weight gain at corrected age of 36 weeks was significantly higher in era 2. Also the incidence of early and total confirmed sepsis, total parenteral nutrition induced cholestasis, was lower and the duration of hospitalization was significantly shorter in era 2 compared to era 1, without differences in the incidence of NEC, moderate to severe BPD, and severe IVH (> or =Gr III) between two eras. CONCLUSION: Early enteral trophic feeding in ELBWI within 24 hours after birth was safe and beneficial.