Early total enteral feeding in stable preterm infants: a systematic review and meta-analysis

Objective: To evaluate safety and feasibility of early total enteral feeding (ETEF) in stable preterm infants. Study design: Systematic review and meta-analysis of randomized trials comparing incidence of necrotizing enterocolitis (NEC) and feeding intolerance between ETEF and slow rates of enteral feed advancement. Results: Four trials involving 393 very low birth weight (VLBW) infants with birth weight >1000-1200 g were included. Meta-analyses did not show statistical difference in risks for NEC (RR 0.87, 95% CI 0.19-3.98) and feeding intolerance (RR 0.78, 95% CI 0.39-1.59). ETEF resulted in lower risk of late-onset sepsis (RR: 0.43, 95% CI: 0.30-0.61). Length of hospital stay was reduced in ETEF (mean difference -1.31 days, 95% CI: -1.54 to -1.07). Conclusions: ETEF appears to be safe and feasible in stable VLBW infants with birth weight >1000-1200 g. A large randomized trial is needed to confirm benefits.

Automated summary

This study evaluated the safety and feasibility of early total enteral feeding (ETEF) in stable preterm infants, showing that ETEF reduced the risk of late-onset sepsis and shortened the length of hospital stay. Further large randomized trials are needed to confirm these benefits.