High-volume feeding safely promotes growth in very preterm infants

In very preterm infants, high-volume feeding is an effective way of promoting faster growth without causing adverse effects, a recent study has found.

Researchers randomly assigned 224 infants, born <32 weeks of gestation and with birthweight 1,001–2,500 g, to receive either a higher-volume (180–200 mL/kg/d; n=104) or a usual-volume (140–160 mL/kg/d; n=104) feeding regimen. The primary outcome was growth velocity in the domains of weight, head circumference, length, and mid-arm circumference.

Those assigned to the high-volume feeding programme showed greater mean growth velocity relative to their usual-volume counterparts (20.5±4.5 vs 17.9±4.5 g/kg/d; p<0.001).

Similarly, at study completion, infants who were fed a higher volume showed significantly higher weight (2,356±324 vs 2,200±307 g; p<0.001), head circumference (31.9±1.3 vs 31.4±1.3 cm; p=0.01), length (44.9±2.1 vs 44.4±2.0 cm; p=0.04), and mid-arm circumference (8.8±0.8 vs 8.4±0.8 cm; p=0.002).

Postnatal growth failure was also more common, though nonsignificantly, in the usual-volume group (21 percent vs 12 percent; p=0.07).

Caloric intake was greater in the high-volume feeding group (134 vs 122; p<0.001), which was driven primarily by feeding volume; caloric density was comparable between arms at study completion.

In terms of side effects, researchers reported no significant between-arm differences in terms of length of stay, bronchopulmonary dysplasia, necrotizing enterocolitis, duration of respiratory support, and feeding intolerance, among other potential adverse events.

“Higher-volume feedings may be a safe and effective way to improve postnatal growth in infants born very preterm,” researchers said.