Randomised controlled study of clinical outcome following trophic feeding

Aims-To determine the effect of trophic feeding on clinical outcome in ill preterm infants. Methods-A randomised, controlled, prospective study of 100 preterm infants, weighing less than 1750 g at birth and requiring ventilatory support and p arenteral nutrition, was performed. Group TF (48 infants) received trophic feeding from day 3 (0.5-1 ml/h) along with parenteral nutrition until venti latory support finished. Group C (52 infants) received parenteral nutrition alone. "Nutritive" milk feeding was then introduced to both groups. Clinic al outcomes measured included total energy intake and growth over the first six postnatal weeks, sepsis incidence, liver function, milk tolerance, dur ation of respiratory support, duration of hospital stay and complication in cidence. Results-Groups were well matched for birthweight, gestation and CRIB scores . Infants in group TF had significantly greater energy intake, mean differe nce 41.4 (95% confidence interval 9, 73.7) kcal/kg p=0.02; weight gain, 130 (CI 1, 250) g p = 0.02; head circumference gain, mean difference 0.7 (CI 0 .1, 1.3) cm, p = 0.04; fewer episodes of culture confirmed sepsis, mean dif ference -0.7 (-1.3, -0.2) episodes, p = 0.04; less parenteral nutrition, me an difference -11.5 (CI -20, -3) days, p = 0.03; tolerated full milk feeds (165 ml/kg/day ) earlier, mean difference -11.2 (CI -19, -3) days, p = 0.03 ; reduced requirement for supplemental oxygen, mean difference -22.4 (CI-41 .5, -3.3) days, p 0.02; and were discharged home earlier, mean difference - 22.1 (CI -42.1, -2.2) days, p = 0.04. There was no significant difference i n the relative risk of any complication. Conclusions-Trophic feeding improves clinical outcome in ill preterm infant s requiring parenteral nutrition.