Effectiveness of early enteral feeding on health outcomes in preterm infants: an overview of systematic reviews

Early enteral feeding is vital for the physical health of preterm infants. However, there is uncertainty regarding the effects of early enteral feeding on health outcomes in preterm infants. Hence, we aimed to synthesise evidence from systematic reviews (SRs) to evaluate the effects of early enteral feeding on health outcomes in preterm infants. We conducted a literature search in PubMed, Web of Science, Scopus, and the Cochrane Database of Systematic Reviews. SRs selection followed clear inclusion and exclusion criteria. Two reviewers reached a consensus for the inclusion of SRs. The certainty of evidence and the quality of reviews using the GRADE and AMSTAR tools, respectively. We included nine SRs in this review. The effectiveness of early enteral feeding on health outcomes in preterm infants is mainly divided into six primary outcomes: increase the weight gain, reduce the incidence of feed intolerance, shorten the duration of full enteral feeding, reduce the length of hospital stay, reduce the incidence of necrotizing enterocolitis, and decrease the mortality risk. The overall quality of the included SRs was high, whereas most of the evidence was of low or very low certainty. Our results show the impact of early enteral feeding on health outcomes in preterm infants. Although the currently available data indicate that early enteral feeding may improve the health outcomes of preterm infants, additional clinical observation and investigation are required to evaluate the long-term health outcomes of preterm infants who receive early enteral feeding.

Automated summary

This review aimed to evaluate the effects of early enteral feeding on health outcomes in preterm infants. Nine systematic reviews were included, showing that early enteral feeding may improve weight gain, reduce feed intolerance, shorten feeding duration, decrease hospital stay, lower the incidence of necrotizing enterocolitis and mortality risk. However, the certainty of evidence was generally low, indicating a need for further research to assess long-term outcomes.