Two-hourly Feeding versus Three-hourly Feeding for Attaining Early Enteral Feed in Low-birth-weight Preterm Babies: A Randomised Controlled Trial

Abstract

Introduction: There has been no consensus on whether a two-hour or three-hour feeding interval is safe and economical for preterm neonates. The parameters like feeding tolerance, the occurrence of infection and time required to attain full enteral feed and other outcome need to be clinically proven. Aim: To investigate whether two-hourly or three-hourly feeding interval is better in preterm neonates to ensure full enteral feeding in lesser time. Materials and Methods: The present randomised controlled trial was conducted in the Department of Paediatrics, Kempegowda Institute of Medical Sciences, Bangalore, Karnataka, India, from January 2021 to June 2021. Hundred preterm neonates, less than 36 weeks of gestation with birth weights between 1 kg and 1.8 kg, were included in the study. Group 1 was subjected to three-hourly feedings and group 2 were subjected to two-hourly feedings. An independent t-test or Mann-Whitney U test was used to analyse GA, birth weight and time of achievement of full feeds. In addition, Chi-square test was used to analyse categorical data. Results: Total 100 neonates were included, in which the age ranged from 5-13 days. There were 50 male and 50 female babies in the present study. Mean time of attainment of full feeds in group 2 was significantly higher (13.72±3.54 days) than group 1 (11.94±3 days). The mean time of achievement of fullfeeds birth weight 1-1.5 kg was 12.86 days in 3-hourly schedules, and 14.67 days in 2-hourly schedules. When the gestational age increased, the time of achievement of full feeds decreased. Conclusion: The time to achieve full feeds was better in 3-hourly feeding schedules compared to 2-hourly schedules. The feed tolerance was also better in 3-hourly feeding schedules. The incidence of complications was lesser in 3-hourly compared to 2-hourly feeding schedules.