Factors Related to Full Enteral Feeding achievement in very low birth weight infants

Introduction: Many feeding guidelines recommend early and progressive enteral feeding, but it is a challenge to feed premuture infants because of the immaturity of the gastrointestinal tract and fear of necrotizing enterocolitis as well as various comorbidities and nonspecific signs of feeding intolerance. Determining the factors affecting the success of full enteral feeding (FEF) is important to improve the nutritional management, and short and long term outcomes of very low birth weight (VLBW) infants. The purpose of this study is to evaluate the effect of clinical conditions or feeding-related factors on FEF achievement in VLBW infants. Method: A retrospective, single-center cohort study was conducted on preterm infants with birth weight < 1500 g and gestational age ≤32 weeks. Feeding of 10-20 ml/kg/day, preferably with breastmilk was started from the first day of stable prematurity. The amount of nutrition was increased to 20-35 ml/kg/day. In unstable high-risk babies, minimal enteral feeding was administered for the first 3-7 days, followed by an increase of 20 ml/kg/day. Results: The median time to reach FEF was 13 days (9-18). In univariate analysis, factors associated with longer time to achieve full feeds were preeclampsia, small for gestational age (SGA), delivery room intubation, significant patent ductus arteriosus (hsPDA), late onset sepsis and formula feeding. Multivariate regression analysis revealed that SGA, hsPDA and formula feeding were independently associated with longer time to achieve FEF. Conclusion: In our study evaluating VLBW babies, being SGA, the presence of hsPDA and formula feeding were found to be factors that negatively affected FEF success. Efforts should be undertaken to enhance the nutritional care of VLBW infants, aiming to mitigate potential complications arising from delayed attainment of FEF.