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Intermittent Bolus or Semicontinuous Feeding for Preterm Infants?

Objectives: The aim of the present study was to assess the clinical benefits and risks of semicontinuous (CON) versus intermittent nasogastric tube feeding in low-birth-weight infants. Methods: Infants with a birth weight <1750 g and gestational age <32 weeks were stratified according to birth weight and assigned to either CON or intermittent bolus (BOL) feeding. The primary endpoint was days to full enteral feeding (defined as 120 mL · kg−1 · day−1). We also collected data on feeding tolerance, weight gain, respiratory support, and complications (sepsis, necrotising enterocolitis, and death). Results: There was no difference between the 2 groups (CON n = 121, BOL n = 125) in days to reach full enteral feeding—7 (5–10) versus 6 (5–8) days, respectively, with a difference 1 (−0.05 to 2.1). Mean daily gastric residual volumes, however, were significantly lower in the BOL group (4.8 vs 3.9 mL/day, difference 0.9 mL/day [0.1–1.7]), as was the total number of patients with feeding interruptions (76 vs 59, difference 16% [3%–28%]). Conclusions: Bolus and continuous feeding are equally suitable feeding strategies for preterm neonates. BOL feeding, however, may be preferable.