Impact of Feeding Interval of Preterms on the Time of Transition From Tube Feeding to Oral Feeding
Impact of Feeding Interval of Preterms on the Time of Transition From Tube Feeding to Oral Feeding
Preterms are usually fed with intervals of either two or three hours during their stay in
 neonatal intensive care unit. Recommendations of World Health Organization about feeding
 regimens, 3-hourly for infants 1500 - 2000 gr, and 2-hourly for infants 1000 - 1500 gr, are
 not proposed with regards to results of randomized controlled trials. Investigators aimed to
 investigate the impact of 2-hourly feeding on time of transition from orogastric to oral
 feeding.
Preterms are usually fed with intervals of either two or three hours during their stay in
 neonatal intensive care unit. Recommendations of World Health Organization about feeding
 regimens, 3-hourly for infants 1500 - 2000 gr, and 2-hourly for infants 1000 - 1500 gr, are
 not proposed with regards to results of randomized controlled trials.

 Stomach volume of preterms varies a wide range of upto 20 ml. This should be taken into
 consideration during the process of feeding of preterms in neonatal intensive care unit.
 Trials were focused on early neonatal outcomes and it was found that duration of phototherapy
 and nasal noninvasive ventilation, and time to achieve full enteral feeds were shorter during
 2-hourly feeding when compared to 3-hourly feeding, on the other hand 3-hourly feeding was
 shown to accelerate the stomach emptying. Besides, duration of catheterization, and ratio of
 feeding intolerance, apnea, and hypoglycemia were found to be similar infants who fed either
 2 or 3-hourly.

 Investigators aimed to investigate the impact of two feeding regimens, 2-hourly or 3-hourly,
 on time of transition from orogastric to oral feeding in preterms.

 Patients and Methods: Preterms of birth weight less that 1500 gr and gestational age smaller
 than 32 weeks are going to be eligible for study if no congenital anomalies exist. Regarding
 current clinical protocol infants are fed every 2 hours until they weigh 1500 gr, and every 3
 hours afterwards. At the day that the infants reach 1500 gr of body weight, a randomization
 will be performed in to two groups, Intervention group: Q2 interval (2-hourly feeding) or
 Control group: Q3 interval (3-hourly feeding), due to study protocol. Infants with inherited
 metabolic disorders, congenital anomalies, neonatal sepsis, and surgical diseases and the
 ones who fed with exclusively formula will be excluded.

 After randomization infants will be followed until discharge. The type of feeding, volume of
 each feed, weight gain per week, feeding intolerance (abdominal distention, vomiting, apnea,
 newly onset or increase of oxygen treatment demand), day of first oral feeding, time of
 transition from orogastric tube to oral feeding, duration of hospitalization will be
 recorded.
Inclusion Criteria:

 1. birth weight <= 1500 gr gr

 2. gestational age <= 32 weeks

 3. postnatal age at randomization: between 7 - 90 days

 Exclusion Criteria:

 -  congenital anomaly

 -  multi organ failure

 -  sepsis

 -  surgical pathology

 -  inherited metabolic diseases

 -  exclusively formula feeding