Background and aims Postnatal growth restriction is common among very preterm infants (VPI). Optimising enteral feeding is of critical importance to improve neurodevelopmental outcome. We assessed the effect of a feeding regimen with a high enteral volume intake.
Design Retrospective population based study of all VPI (GA < 30 weeks) discharged from a single NICU between 2005–2010. Baseline clinical data, enteral volume intake and postnatal growth data were collected. Weight at birth/discharge and at 1 year of corrected age was converted to standard deviation (SD; Z) scores.
Results 99 infants were included. Infants who died (15/99; 15%) had lower mean GA than infants who survived to discharge (24.9 weeks vs. 27.3 weeks). For all infants enteral nutrition was commenced within first 48 h. Two infants developed surgical NEC, both survived. Daily enteral volume of fortified breast milk was 180–200 ml/kg from 3 weeks of age and until self-regulation. Seven infants were transferred to other units < 34 weeks. Among the other 77 infants the mean (SD) Z-scores for weight were; at birth -0.37 (-0.27), at discharge -0.42 (-0.53) and at 1 year corrected age -0.46 (-0.60). The prevalence of SGA (< 10 centile) at birth (13/77; 17%) was similar to SGA prevalence at discharge (14/77; 18%).
Conclusions The rate of postnatal growth restriction was lower than previously reported in similar patient populations. We believe a high enteral volume intake is a safe method to increase energy and protein delivery and thus improve the nutritional status of very preterm infants.