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Войти в исследования The Journal of pediatrics · 2026
Effect of Extended Infusion Versus Intermittent Bolus Feedings on Hospital Weight Gain in Extremely Low Birth Weight Infants Born at <29 Weeks of Gestation: A Randomized Noninferiority Clinical Trial.
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Balasubramanian Haribalakrishna, Sahoo Manoj, Chhadva Darsika, Choubey Richa, Sakharkar Sachin, Pillai Anish, Kabra Nandkishore S
Аннотация
OBJECTIVE: To evaluate if extended infusion-based enteral feeding was noninferior to intermittent bolus feeding for hospital weight gain in infants born at extremely low birth weight (ELBW).
STUDY DESIGN: Infants with ELBW and born at <29 weeks of gestation on minimal enteral nutrition were randomized to feeding advancements as extended milk infusion feeding (5-hour continuous milk infusion followed by 1-hour feeding break) or every 2-hour intermittent bolus feeding. The infusion feeding continued until a postmenstrual age of 30 weeks or postnatal weight of 1.2 kg. The primary outcome was in-hospital weight gain (g/kg/day) assessed using 2-point average model with a noninferiority margin of -2.
RESULTS: We randomized 132 infants (infusion, n = 68; bolus, n = 64). The median gestational age and birth weight were 26.4 ± 1.2 weeks and 752 ± 140 g. The infusion group received infusion feedings for an average of 47 days (IQR: 44-53). The median time to full enteral feedings was similar (infusion: 10 days [IQR: 7-12]; bolus: 9 days [IQR: 7-12], P = .82). The mean (SD) rate of weight gain at discharge was 15.3 ± 2.6 g/kg/day vs 15.7 ± 2.8 g/kg/day (mean difference: -0.4 g/kg/day, lower limit of the one-sided 97.5% CI: -1.15 g/kg/day, per protocol analysis). The infusion group had significantly fewer days of feeding interruptions (6.7 days [5.6-8.1] vs 8.7 [7.4-10.1] per 100 patient days, P = .03) in the first 28 days. Duration of hospitalization and morbidities were similar in study groups.
CONCLUSIONS: Among infants with ELBW that achieve early enteral feedings, extended infusion feeding was noninferior to bolus feedings for hospital weight gain.
TRIAL REGISTRATION: http://www.ctri.nic.in (CTRI/2022/12/047946).
STUDY DESIGN: Infants with ELBW and born at <29 weeks of gestation on minimal enteral nutrition were randomized to feeding advancements as extended milk infusion feeding (5-hour continuous milk infusion followed by 1-hour feeding break) or every 2-hour intermittent bolus feeding. The infusion feeding continued until a postmenstrual age of 30 weeks or postnatal weight of 1.2 kg. The primary outcome was in-hospital weight gain (g/kg/day) assessed using 2-point average model with a noninferiority margin of -2.
RESULTS: We randomized 132 infants (infusion, n = 68; bolus, n = 64). The median gestational age and birth weight were 26.4 ± 1.2 weeks and 752 ± 140 g. The infusion group received infusion feedings for an average of 47 days (IQR: 44-53). The median time to full enteral feedings was similar (infusion: 10 days [IQR: 7-12]; bolus: 9 days [IQR: 7-12], P = .82). The mean (SD) rate of weight gain at discharge was 15.3 ± 2.6 g/kg/day vs 15.7 ± 2.8 g/kg/day (mean difference: -0.4 g/kg/day, lower limit of the one-sided 97.5% CI: -1.15 g/kg/day, per protocol analysis). The infusion group had significantly fewer days of feeding interruptions (6.7 days [5.6-8.1] vs 8.7 [7.4-10.1] per 100 patient days, P = .03) in the first 28 days. Duration of hospitalization and morbidities were similar in study groups.
CONCLUSIONS: Among infants with ELBW that achieve early enteral feedings, extended infusion feeding was noninferior to bolus feedings for hospital weight gain.
TRIAL REGISTRATION: http://www.ctri.nic.in (CTRI/2022/12/047946).