Very Low Birth Weight Infants Fed Early Clinical Observation

OBJECTIVE To investigate the effects of early minimal enteral feeding in VLBW on growth and development, gastrointestinal function, feeding complications, and to provide the basis of using early minimal enteral feeding in VLBW.MATERIALS AND METHORDS The study was conducted in the neonatal intensive care unit of Peking Union Medical College Hospital from Feb 2005 to Feb 2006. 29 infants who met the entry criteria were assigned to two groups. In early feeding group, infants were received early MEF before 24 hours after birth. Initial from 12ml/kg/d, gradually advancing the volume of feed depending on the condition of the infants. In control group, infants were received feeding after 24 hours after birth.15 infants in early feeding group, gestational age 30.4±1.7w, birth weight 1353±156g;14 infants in control group ,gestational age 30.0±1.5w, birth weight 1275±211g.No significant difference between two groups. Growth and development, tolerance to enteral feedings, serum gastfin and motilin concentrations, electrogastrography, gastrointestinal motility, SMA haemodynamics were monitored.RESULTS Compared with control group, growth and development, time to full enteral feeds, PN time and hospital days difference were not observed. Enteral feeding tolerance were significantly enhanced in early group (P=0.039), serum motilin concentrations were enhanced in day 7(587.3±144.3 vs 418.5±120.7, P=0.003) and day 14(768.3±239.3 vs 517.9±167.6, P=0.004) after birth, no difference on birthday and day 28. No changes in serum gastrin concentrations. Electrogastrography indicated that the proportion of tachygastfia and normal frequency of gastric slow waves were same on day 7 and day 14 after birth. But on day 28 the EGG type were more mature in early feeding group: bradygastria decreased (38.6±21.1% vs 62.9±21.1%, P= 0.020) and 3 cycles per minute (cpm) normal activity increased (39.0±19.9 %vs 22.1±19.6%, P=0.047) .The complete passage of meconium time was 263.5h in early feeding group, 325.1h in control group(p=0.038). The complete passage of coccinellin time was same on day 7 and day 14 after birth, but shorter in early feeding group on day 28 (263.5±75.9h vs. 325.1±76.1h, P=0.038). SMA haemodynamics no statistic difference. CONCLUSION Our initial study indicates that early minimal enteral feeding can enhanced maturation of the small intestine function, lessen feeding intolerance, included lessen feeding complications, enhanced serum motilin concentrations, enhanced maturation of gastric electric control activity, enhanced gastrointestinal motility.