Intermittent Bolus or Semicontinuous Feeding for Preterm Infants?

Objectives: The aim of the present study was to assess the clinical benefits and risks of semicontinuous ( CON) versus intermittent nasogastric tube feeding in low- birth- weight infants. Methods: Infants with a birth weight < 1750 g and gestational age < 32 weeks were stratified according to birth weight and assigned to either CON or intermittent bolus ( BOL) feeding. The primary endpoint was days to full enteral feeding ( defined as 120 mL center dot kg -1 center dot day-1). We also collected data on feeding tolerance, weight gain, respiratory support, and complications ( sepsis, necrotising enterocolitis, and death). Results: There was no difference between the 2 groups ( CON n = 121, BOL n = 125) in days to reach full enteral feeding- 7 ( 5- 10) versus 6 ( 5- 8) days, respectively, with a difference 1 ( - 0.05 to 2.1). Mean daily gastric residual volumes, however, were significantly lower in the BOL group ( 4.8 vs 3.9 mL/ day, difference 0.9 mL/ day [ 0.1- 1.7]), as was the total number of patients with feeding interruptions ( 76 vs 59, difference 16% [ 3%- 28%]). Conclusions: Bolus and continuous feeding are equally suitable feeding strategies for preterm neonates. BOL feeding, however, may be preferable.