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Journal of the American College of Nutrition, Vol. 19, No. 6, 797-800 (2000)
Published by the American College of Nutrition

Original Research

Feeding Tolerance in Preterm Infants: Randomized Trial of Bolus and Continuous Feeding

Shaul Dollberg, MD, Jacob Kuint, MD, Ram Mazkereth, MD and Francis B. Mimouni, MD, FACN

Department of Neonatology, Lis Maternity Hospital, Tel Aviv (S.D., F.B.M.), ISRAEL
Department of Neonatology, Sheba Medical Center, Tel Hashomer (J.K., R.M.), ISRAEL

Address reprint requests to: Francis B. Mimouni, MD, Department of Neonatology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv, 64239, Israel. E-mail: mimouni{at}tasmc.health.gov.il

Objective: To test the hypothesis that continuous gastric infusion (CGI) is better tolerated than intermittent gastric bolus (IGB) in small very low birth weight (VLBW) infants.

Design: Two-center, prospective, randomized, unmasked clinical trial.

Patients: 28 VLBW infants (birth weight <1250 g). A strict feeding protocol was followed.

Intervention: Patients were randomized to IGB or CGI.

Main outcome measures: Time to reach full feeds (160 cc/kg/d)(by design and real), daily weight, caloric intake, residual gastric volume and type of feeding (formula vs. human milk vs. both).

Results: Five infants failed to complete the study because of death (n = 4) or protocol violation (n = 1). The two groups did not differ by birth weight or gestational age; infants fed via IGB reached full feeds earlier (p = 0.03) and had less delay in reaching full feeds than infants fed via CGI.

Conclusion: Contrary to our hypothesis, gravity IGB is more effective than CGI in improving feeding tolerance in small VLBW infants.

Key words: prematurity, infant nutrition, weight gain

Abbreviations: CGI = continuous gastric infusion • IGB = intermittent gastric bolus




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