PEDIATRICS Vol. 77 No. 3 March 1986, pp. 275-280
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Early Enteral Feeding Does Not Affect the Incidence of Necrotizing Enterocolitis

S. G. Ostertag MNS, RD1, E. F. LaGamma MD1, C. E. Reisen MD1, and F. L. Ferrentino MD1

1 The Perinatology Center, Department of Pediatrics, New York Hospital-Cornell Medical Center, New York

To begin to determine the optimal time for initiating enteral feedings, 34 sick, very low birth weight infants were prospectively selected from all neonates of less than 1,500 g (N = 116) and randomly divided into two groups. Infants were fed either on day 1 (early) or 7 (late) of life, according to a feeding protocol which included parenteral nutrition and a scheduled progression from sterile water to 2.5% dextrose, half-strength, and finally full-strength formula over seven days. The incidence of necrotizing enterocolitis and subsequent hospital course were compared. Initiating enternal feedings on day 1 did not significantly increase the incidence of necrotizing enterocolitis, produce a clustering of cases, or induce an earlier onset of necrotizing enterocolitis. The overall incidence of necrotizing enterocolitis in sick, very low birth weight neonates was 29% (5/17) and 35% (6/17) in the early and late groups, respectively, compared with 4.2% (2/47) in minimally sick, very low birth weight neonates. No significant differences between groups were seen in obstetrical complications, birth weight, gestational age, Apgar scores, presence of patent ductus arteriosus or intraventricular hemorrhage, use of umbilical catheterization, and respiratory or oxygen requirements. Infants fed enterally from day 1 did show a significantly higher energy and protein intake during the second week of life. These data show that providing dilute, early enteral calories does not adversely affect the incidence of necrotizing enterocolitis.

Key Words: necrotizing enterocolitis • neonate • enteral feeding • prematurity

Submitted on June 10, 1985
Accepted on August 27, 1985




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