Early Feeding Advancement in Very Low‐Birth‐Weight Infants With Intrauterine Growth Retardation and Increased Umbilical Artery Resistance

Abstract

ABSTRACTBackgroundTo investigate whether intrauterine growth retardation (birth weight <10th percentile), increased umbilical artery resistance (resistance index >90th percentile measured by Doppler velocimetry), or brain sparing (increased umbilical artery resistance and decreased middle cerebral artery resistance index <5th percentile) were associated with early feeding intolerance in very low‐birth‐weight (VLBW, <1,500 g) infants.MethodsFrom July 1999 to December 2000, 124 inborn VLBW infants were enrolled in a prospective trial evaluating early enteral nutrition after a standardized feeding protocol (daily feeding advancement, 16 mL/kg birth weight). Feeding tolerance was assessed as the age at which full enteral feeds (150 mL/kg daily) were achieved. Data are shown as median, 25th, and 75th percentiles.ResultsFull enteral feeds were achieved at 15 days (range, 12–21 days) of age for all infants. Intrauterine growth retardation (full enteral feeding achieved at 14 days; range, 12–21 days), increased umbilical artery resistance (full enteral feeding achieved at 14 days; range, 11–16 days), and brain sparing (full enteral feeding achieved at 15 days; range, 14–20 days) were not associated with early feeding intolerance.ConclusionVery low‐birth‐weight infants with intrauterine growth retardation, increased umbilical artery resistance, and brain sparing tolerated enteral feeding as well as appropriate‐for‐gestational‐age VLBW infants.