J Korean Soc Neonatol.  2009 Nov;16(2):121-130.

Enteral Feeding for Preterm Infants-Benefits and Risks

Affiliations
  • 1Department of Pediatrics, College of Medicine, Inje University, Busan, Korea. pedsin@inje.ac.kr

Abstract

Over the past 20 years, neonatal mortality rates for preterm infants, particularly those born extremely preterm and with a very low birth weight, have decreased steadily. As more very immature preterm infants survive, provision of enteral feeding has become a major focus of concern. According to many experts on neonatal nutrition, the goal for the nutrition of preterm infants should be to achieve a postnatal growth rate approximating that of a normal fetus of the same gestational age. Total parenteral nutrition for maintaining nutritional integrity is mandatory before successful transition to enteral feeding. Early initiation of trophic enteral feeding is vital for postnatal adaptation. Recently published randomized controlled trials provide no evidence to support the practice of postponing enteral feeding to reduce the incidence of necrotizing enterocolitis. Early trophic feeding yields demonstrable benefits and there is currently no evidence of any adverse effects following early feeding. Preterm milk from the infant's own mother is the milk of choice, which can always be supplemented with a human milk fortifier. Here we review over 50 randomized controlled trials and over seven systematic reviews published on neonatal parenteral and enteral feeding of preterm infants. Neonatologists must make use of the evidence from these studies as a reference for feeding protocols for preterm infants in their NICUs are to be based.

Keyword

Enteral feeding; Preterm infants; Early trophic feeding

MeSH Terms

Enteral Nutrition
Enterocolitis, Necrotizing
Fetus
Gestational Age
Humans
Incidence
Infant
Infant Mortality
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight
Milk
Milk, Human
Mothers
Parenteral Nutrition, Total
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