The impact of feeding interval on feeding outcomes in very low birth-weight infants

Objective: Test the hypothesis that very low birth-weight (VLBW) infants fed every 2 h (q2) are able to reach full enteral feedings more quickly than infants fed every 3 h (q3). Study Design: We performed a retrospective cohort study comparing q2 infants (n = 103) with q3 infants (n = 251). The primary outcome was days from start of a feeding advance to full feedings (120 ml per kg per day). Multivariable regression models were used to control for maternal and perinatal factors that preceded the initiation of the feeding advance. Result: Infants fed q2 reached full feedings 2.7 days sooner than q3 infants (95% confidence interval (CI) 1.5, 3.9). After adjustment for confounders, q2 infants reached full feedings 3.7 (95% CI 1.6, 5.9) days more quickly. Infants fed q3 were more likely to receive > 28 days of parenteral nutrition (odds ratio (OR) 4.7; 95% CI 1.5, 14.4), and were more likely to have feeds held for >= 7 days (OR 4.7, 95% CI 1.9, 11.7). Conclusion: VLBW infants demonstrate improved feeding tolerance when fed more frequently. Journal of Perinatology (2011) 31, 481-486; doi: 10.1038/jp.2010.153; published online 20 January 2011