Abstract：Objective To study the appropriate time of starting enteral nutrition and observe the effects of different enteral nutrition starting times on the digestive function, growth rate, and nosocomial infection rate in very low birth weight infants (VLBWI). Methods All the VLBWI admitted to the neonatal intensive care unit between February and December, 2012 were selected. Depending on different times of starting enteral nutrition, these infants were divided into three groups: ≤3 days (n=116), 4-6 days (n=36), and ≥7 days (n=26). The effects of different enteral nutrition starting times on digestive function, growth rate and nosocomial infection rate were analyzed. Results The ≤3 days group had significantly higher milk intake than the other two groups at one week after birth; the ≤3 days and 4-6 days group had significantly higher milk intake than the ≥7 days group at two and three weeks after birth. The growth rate showed no significant differences between the three groups. The ≤3 days group had a significantly shorter time of central venous catheterization than the other two groups, and the ≥7 days group had a significantly longer time to full enteral feeding than the other two groups. The nosocomial infection rate of the ≤3 days group (13.8%) was significantly lower than that of the ≥7 days group (46.2%). Conclusions For VLBWI, the time of starting enteral nutrition has no impact on growth rate, but starting enteral nutrition early can promote the development of gastrointestinal function, increase milk intake, shorten the time to full enteral feeding, reduce the time of central venous catheterization, and significantly reduce nosocomial infection rate.
YU Xin-Ying,FAN Ling. Effects of enteral nutrition starting time on digestive function and growth rate in very low birth weight infants[J]. CJCP, 2014, 16(8): 814-819.
Ehrenkranz RA. Earlier, aggressive nutritional management for very low birth weight infants: What is the evidence?[J]. Semin Perinatol, 2007, 31(2): 48-55.
[3]
Kennedy KA, Tyson JE. Early versus delayed initiation of progressive enteral feedings for parenterally fed low birth weight or preterm infants[J]. Cochrane Database Syst Rev, 2008(2): CD001970.
Lau C. Oral feeding in the preterm infant[J]. Neo Reviews, 2006, 7: e19-e27.
[10]
Adamkin DH. Early aggressive nutrition:parenteral aminoacids and minimal enteral nutrition for extremely low birth weight (<1 000 g) infants[J]. Minerva Pediatr, 2007, 59(4): 369-377.
[11]
Neu J. Gastroint estinal development and meeting the nutritional needs of premature infants[J]. Am J Clin Nutr, 2007, 85(2S): 629-634.
[12]
Dinerstein A, Nieto RM, Solana CL, et al. Early and aggressive nut- ritional strategy(parenteral and enteral) decreases postnatal growth failure in very low birth weight infants[J]. J Perinatol, 2006, 26(7): 436-442.
[13]
Boo NY, Soon CC, Lye MS. Risk factors associated with feed intolerance in very low birth weight infants following initiation of enteral feeds during the first 72 hours of life[J]. J Trop Pediatr, 2000, 46(5): 272-277.
Verma RP. Clinical determinants and utility of early postnatal maximum weight loss in fluid management of extremely low birth weight infants[J]. Early Hum Dev, 2009, 85(1): 59-64.
[20]
Stoll BJ, Hansen N, Fanaroff AA, et al. Late-onset sepsis in very low birth weight neonates: the experience of the NICHD neonatal research network[J]. Pediatrics, 2002, 110(2 pt 1): 285- 291.
[21]
Perlman SE, Saiman L, Larson EL. Risk factors for late-onset healthcare-associated bloodstream infections in patients in neonatal intensive care units[J]. Am J Infect Control, 2007, 35(3): 177-182.
Stoll BJ, Hansen N, Fanaroff AA. Changes in pathogens causing early-onset sepsis in very-low-birth-weight-infants[J]. N Engl JMed, 2002, 347(4): 240-247.
