Feeding the Low Birth Weight Infant: Orally or Parenterally? Preliminary Results of a Comparative Study

Abstract

Fifteen normally grown premature (NG-P), seven intrauterine growth retarded premature (IGR-P) and six intrauterine growth-retarded mature (IGR-M ) neonates were randomly assigned to oral (PO) or parenterally supplemented (SUP) oral feeding regimens. Supplemented babies did not have greater mean caloric intakes.

Although supplementation in the NG-P group decreased postnatal weight loss, reduced the time to regain and maintain birth weight and increased the mean daily weight gain during supplementation, mean daily weight gains during the whole hospital course and the babies' weight and postconceptional age at discharge were similar for both feeding regimens. For the most part, the same trends were evident in the ICR group. These data and the fact that mean daily increases of other growth parameters (length, head circumference, skinfolds) were not influenced by mode of feeding suggest water retention rather than tissue accretion as an explanation for the early postnatal weight "advintage" in the SUP group.

Severe metabolic disturbances (hyperglycemia, serum and urine hyperosmolality, metabolic acidosis) were the rule in the premature neonates with infusate glucose concentrations in excess of 12 gm/100 ml or with amino acid concentrations higher than 2 gm/100 ml. Two of seven neonates supplemented by central catheter developed sepsis arid died whereas no systemic infections occurred in the PO or peripherally supplemented babies.