A randomized trial of enteral feeding volumes in infants born before 30 weeks' gestation

Objective: To compare the effect of two volumes of enteral feeds on postnat al growth in infants born before 30 weeks gestation. Methodology: Fifty-four infants, less than 30 weeks gestational age, who re ached full enteral feeds were randomized to remain on 150 mL/kg per day (15 0 group) or increase to 200 mL/kg per day (200 group). The primary outcome measure was growth at 35 weeks corrected gestational age (CGA). Results: There were no statistically significant differences in demographic or clinical parameters between the study groups at commencement of the stu dy, although there was a trend for infants in the 150 group to be lighter ( 895 g vs 1020 g, P = 0.27). Milk intakes were increased in 43% of the infan ts in the 150 group, whereas 54% of the infants in the 200 group required r educed intakes. Infants in the 200 group had greater daily weight gains (16 .7 g/kg per day vs 15.2 g/kg per day, P = 0.047) and at 35 weeks CGA were h eavier (2020 g vs 1885 g, P = 0.014) and had a greater arm fat area (282 mm (2) vs 218 mm(2), P = 0.009). There was no difference in length or head cir cumference at 35 weeks CGA, and no difference in any growth parameter at 1 year of age. Morbidity was not different between the groups. Conclusions: The individual milk volume requirements for adequate weight ga in without significant adverse effects vary between 150 and 200 mL/kg per d ay in extremely premature infants. For many infants in both groups, the ass igned target volume was not appropriate. Increased milk intakes (and theref ore higher caloric and mineral intakes) are associated with increased daily weight gains and a greater weight at 35 weeks CGA. The weight gain may be due to an increase in fat deposition.