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ARS Home » Plains Area » Houston, Texas » Children's Nutrition Research Center » Research » Publications at this Location » Publication #69324
Title: RANDOMIZED TRIAL OF BOLUS VS CONTINUOUS TUBE-FEEDING IN PREMATURE INFANTS

Author
item SCHANLER, RICHARD - BAYLOR COLL OF MEDICINE
item SHULMAN, ROBERT - BAYLOR COLL OF MEDICINE
item LAU, CHANTAL - BAYLOR COLL OF MEDICINE

Submitted to: Pediatric Research
Publication Type: Abstract Only
Publication Acceptance Date: 5/6/1996
Publication Date: N/A
Citation: N/A

Interpretive Summary:

Technical Abstract: To determine the optimal method for tube-feeding premature infants we conducted a randomized trial of bolus (B) vs continuous (C) feeding in premature infants stratified by gestational age and intent to breast feed. Growth, feeding tolerance, medication usage, nutrient absorption, lactase activity, and intestinal permeability were assessed. Groups B (n=81) and C (n=77) were similar in birth weight (1.0 +/- 0.2 kg, mean +/- SD), gestation (28 +/- 1 wk), receipt of antenatal steroids (B:n=39,C:n=47), deaths (B:n=6,C:n=4), necrotizing enterocolitis (B:n=13,C:n=8), sepsis (B:n=31,C:n=36), need for GI surgery (B:n=9,C:n=10), and receipt of oxygen, steroids, diuretics, and duration of parenteral nutrition. Milk was initiated at 11 +/- 6 d in each group. Group B achieved full tube-feeding sooner than C (26 +/- 8 vs 35 +/- 29 d, p=0.05). Feeding tolerance, as measured by the % occurrence of any gastric residual volume greater than 0 ml (41 +/- 12% vs 56 +/- 12%, p<0.001), greater than 2 ml/kg (9 +/- 8% vs 17 +/- 7%, p less than 0.001), and greater than 50% of 3-h feeding (1 +/- 2% vs 2 +/- 3%, p=0.04) was significantly more common in B than C. Group B needed significantly less therapy for gastroesophageal reflux than C (p=0.03). There were no differences in the absorption and retention of nitrogen, fat, calcium, phosphorus, zinc, or copper between Groups B and C. Bolus feeding is associated with more rapid attainment of full tube-feeding ter feeding tolerance, less need for anti-reflux therapy.