EFFECT OF EARLY VERSUS LATE ENTERAL FEEDING IN PRETERM INFANTS ON THE INCIDENCE OF NECROTIZING ENTEROCOLITIS. A RANDOMIZED CLINICAL TRIAL

Dr. Mahfoud Eid*

ABSTRACT

Objective: The debate continues regarding the optimal timing for initiating enteral feeding and the rate of advancement in meal volume, due to concerns about predisposing young preterm to necrotizing enterocolitis (NEC). The aim of this study was to compare the effect of early versus late enteral feeding on the incidence of NEC. Methods: Overall, 60 preterm babies born between 28 and 34 weeks of gestation, admitted to the neonatal intensive care unit (NICU) between March 2023 and April 2024 were included. Based on whether enteral feeding was initiated within or after 48 hours since birth, the infants were divided into an early enteral feeding (EEF) group and a late enteral feeding (LEF) group. Results: Two cases (6.7%) of NEC were recorded in EEF group compared to one case (3.3%) in the LEF group. However, there was no significant difference in the incidence of NEC between the two groups (P = 0.5). In comparison with the LEF group, the EEF group was associated with a statistically significant decrease in the length of hospital stay, duration of total parenteral nutrition (TPN) use, and time to achieve full enteral nutrition (all P < 0.05). The daily weight gain was significantly higher in the EEF group compared to the LEF group (P = 0.0001). Conclusions: Early enteral feeding was associated with accelerated attainment of full nutrition, reduced duration of total parenteral nutrition and its potential complications, shortened hospital stay, without an increased risk of developing necrotizing enterocolitis.

Keywords: Preterm, Enteral Feeding, Necrotizing Enterocolitis, Trophic Feeding.