Early total enteral feeding versus conventional incremental feeding in preterm infants weighing 1000-1250 g: a single-center open-label randomized controlled trial

作者：Mishra A, Raha SJ, Kumar J, Bandyopadhyay T, Debata PK · 发表于：European journal of pediatrics · 年份：2026 · DOI：10.1007/s00431-026-07321-7 · 研究领域：Enteral Nutrition、Infant, Premature、Infant, Very Low Birth Weight、Humans、Infant, Newborn、Female、Male、Enterocolitis, Necrotizing、Treatment Outcome、Parenteral Nutrition、Sepsis、Time Factors

UNLABELLED: Early total enteral feeding (ETEF) may reduce exposure to intravenous fluids and parenteral nutrition in preterm infants. However, evidence regarding its safety and effectiveness remains limited, particularly among preterm infants with a birth weight of 1000-1250 g. We compared ETEF with conventional enteral feeding (CEF) in this population. In this single-center, open-label, randomized controlled trial, preterm infants (≤ 34 weeks' gestation) with birth weights of 1000-1250 g were randomized to ETEF (80 mL/kg/day enteral feeds from day 1; n = 87) or CEF (30 mL/kg/day enteral feeds with intravenous fluid or parenteral nutrition; n = 83). The primary outcome was time to attain full enteral feeding (150 mL/kg/day). Secondary outcomes included feed intolerance, necrotizing enterocolitis (NEC), sepsis, mortality, time to regain birth weight, and duration of intravenous fluid. A total of 170 infants were randomized and followed up. The median (IQR) time to attain full enteral feeds was similar between the ETEF and CEF groups (6.5[5-10] vs. 6.5[5-11] days; p=0.40). Infants receiving ETEF regained birth weight earlier (16[11.5-19] vs. 18.5[13.8-26] days; p=0.008) and required intravenous fluid for a shorter duration (3[0-6] vs. 6[4-9] days; p<0.001). Feed intolerance, NEC, sepsis, hospital stay, and mortality were comparable between the two groups. CONCLUSION: Early total enteral feeding did not improve the time to achieve full enteral feeding compared with CEF. However...