Strategies to improve feeding tolerance in preterm infants.

J Matern Fetal Neonatal Med

Neonatal Intensive Care Unit, Paediatric Section, University of Ferrara, Italy.

Published: October 2012

AI Article Synopsis

  • Postnatal growth restriction and failure to thrive are critical issues for preterm infants, particularly those with extremely low birth weight, necessitating careful management of enteral nutrition.
  • The challenge for neonatologists lies in balancing the goal of achieving full enteral feedings with the risk of necrotizing enterocolitis (NEC), a serious condition that significantly contributes to mortality and morbidity rates.
  • There is uncertainty regarding the connection between feeding intolerance and NEC, leading to variations in treatment strategies that often lack scientific backing and can result in extended hospital stays.

Article Abstract

Postnatal growth restriction and failure to thrive is a major issue in preterm, especially extremely low-birth-weight infants. Optimization of enteral nutrition, without increasing the risk of necrotizing enterocolitis (NEC), has thus become a priority for the neonatologist, who often has to face the challenge of interpreting the clinical and prognostic significance of common and aspecific signs of feeding intolerance (FI). The neonatologist often prescribes enteral nutrition as if walking on a tightrope between the purposed attainment of full enteral feeding and the fear of NEC. Despite advances in neonatal intensive care, NEC still remains one of the leading causes of mortality (15-30%) and morbidity in very-low-birth-weight infants. However, the relationship between FI and NEC remains unknown. Feeding intolerance often leads to discontinuation of enteral feeds, delayed attainment of full enteral feeding and prolongation of hospitalization. Strategies aimed at preventing and/or treating episodes of feeding intolerance are diverse and not always supported by scientific evidence.

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Source
http://dx.doi.org/10.3109/14767058.2012.715021DOI Listing

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