Background Preterm infants do not always demonstrate adequate cerebral vascular autoregulation (CAR). Higher intestinal demands after enteral feeding may compromise cerebral perfusion in these infants. It remains unclear whether enteral feeding influences cerebral perfusion in preterm infants.

Aim To assess the effect of enteral feeding on regional cerebral oxygen saturation (r_cSO₂) in preterm infants.

Methods This study was part of a larger prospective cohort study. We used near-infrared spectroscopy to measure r_cSO₂, which is indicative for cerebral perfusion.We measured during two hours on postnatal days 2–5, 8, 15, 22, 29, and 36. Feeding times were manually recorded. We used multi-level analyses to compare preprandial r_cSO₂ values to postprandial r_cSO₂ values, both10–30 min and 30–60 min after feeding.

Results We included 29 preterm infants with a median GA of 28+1/7 (range 25+1/7–30+4/7) weeks, and a median birth weight of 1025 (range 580–1495) grams. Compared to preprandial values, we found increased postprandial r_cSO₂ values 10–30 min after feeding (mean[SD]: from 67%[15] to 71%[13], p = 0.014), and 30–60 min after feeding (mean[SD]: from 67%[15] to 73%[14], p = 0.000) on day 8. We observed a trend of decreased r_cSO₂ values 30–60 min postprandial compared to preprandial values on day 15 (mean[SD]: from 66%[11] to 64%[11], p = 0.091).

Conclusion Our results suggest that in preterm infants during their first 36 days of life, cerebral perfusion does not decrease the first hour after feeding. One might reason that most preterm infants may yet be able to regulate cerebral perfusion, or postprandial intestinal perfusion may not increase at all.