EFFECT OF ENTERAL GAVAGE FEEDING RATE ON PULMONARY FUNCTIONS OF VERY-LOW-BIRTH-WEIGHT INFANTS

To compare the effects of intermittent and continuous feedings on pulm onary function, we studied 24 very low birth weight neonates (mean +/- SD: birth weight, 1.2 +/- 0.3 kg; gestational age, 30.5 +/- 1.1 weeks ) at 2 to 4 weeks of age. All infants had a previous diagnosis of resp iratory distress syndrome but no subsequent diagnosis of bronchopulmon ary dysplasia. Pulmonary mechanics were measured before the beginning of intermittent or continuous feedings and 10 minutes after each meal was completed. Twelve infants were randomly assigned to intermittent a nd 12 to continuous feedings. These infants had similar birth weight, gestational age, study age, and baseline lung function. After intermit tent feedings, there was a significant decrease in tidal volume (38%), minute ventilation (44%), and dynamic compliance (28%), whereas pulmo nary resistance increased significantly (100%). In comparison, the pul monary function data remained unchanged after continuous feedings. The se data demonstrate that intermittent feeding of very low birth weight infants can lead to airflow and respiratory instability. These advers e effects appear to be dependent on the rate that feedings are adminis tered. A slower pace of feeding may be more advantageous for infants p rone to respiratory instability.