Premature Infants Benefit from Dual Feeding Approach

Most pediatricians who deal with care of newborn babies suspect that premature infants benefit from both intravenous and conventional feeding. Now, scientists at the Children’s Nutrition Research Center (CNRC) in Houston have evidence--from a study of baby pigs--to support this clinical practice.

The study was led by CNRC physiologist Douglas G. Burrin. The CNRC is cooperatively run by the USDA’s Agricultural Research Service and Baylor College of Medicine.

Premature infants are born with an immature digestive system and require intravenous feeding. But without intestinal feeding, these infants’ digestive systems will be underdeveloped by the time they’re ready to nurse. Introducing intestinal feeding too quickly, however, can cause serious complications and even death.

Some newborn specialists, or neonatologists, work around the dilemma by giving small volumes of food through the intestine while feeding intravenously. Early testing suggested just a small amount of food could prepare the developing intestine for a successful transition.

USDA nutritionists and neonatologists used newborn pigs as a model of pre-term infants to compare intravenous feeding alone with combined intravenous and conventional feeding. They found that providing about 20-30 percent of total intake through intestinal feeding is the optimal minimal requirement for intestinal growth.

This finding could have a significant impact on health care costs. Annually, a quarter of a million U.S. infants are born prematurely. They spend an average of 20 days on intravenous feeding. Previous medical studies show supplementing with small amounts of intestinal feeding cuts that time to 15 days. Since intravenous feeding costs about $2,500 daily, a 5-day reduction could save up to $12,500 per infant, or $3 billion annually nationwide.

But the infants would benefit most of all. Intravenous feeding, while necessary, is linked to slow bone growth and infections. Supplementing with intestinal feeding can improve weight gain, and shorten these infants’ hospital stays. Infants with a more mature intestinal system tolerate feeding better and will learn bottle feeding skills such as sucking and swallowing faster.

Scientific contact: Douglas G. Burrin, Children’s Nutrition Research Center at Baylor College of Medicine, USDA, ARS, Houston, Texas, phone (713) 798-7049; fax (713) 798-7098, dburrin@bcm.tmc.edu