Marita de Waard1, Yanqi Li2, Yanna Zhu3, Adejumoke I Ayede4, Janet Berrington5, Frank H Bloomfield6, Olubunmi O Busari4, Barbara E Cormack6, Nicholas D Embleton5, Johannes B van Goudoever1, Gorm Greisen7, Zhongqian He8, Yan Huang9, Xiaodong Li8, Hung-Chih Lin10, Jiaping Mei11, Paula P Meier12, Chuan Nie13, Aloka L Patel12, Christian Ritz14, Per T Sangild2,15,16, Thomas Skeath5, Karen Simmer17, Olukemi O Tongo4, Signe S Uhlenfeldt7, Sufen Ye11, Xuqiang Ye18, Chunyi Zhang13,19, Ping Zhou9. 1. Department of Pediatrics, Amsterdam UMC, Vrije Universiteit, Emma Children's Hospital, Amsterdam, The Netherlands. 2. Comparative Pediatrics and Nutrition, University of Copenhagen, Copenhagen, Denmark. 3. School of Public Health, Sun Yat-sen University, Guangzhou, China. 4. Department of Pediatrics-Neonatology Unit, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria. 5. Department of Neonatology, Newcastle Hospitals NHS Foundation Trust, Newcastle, United Kingdom. 6. Liggins Institute, University of Auckland and Newborn Service, National Women's Health, Auckland, New Zealand. 7. Department of Neonatology, Rigshospitalet, Copenhagen, Denmark. 8. Department of Neonatology, Shenzhen Nanshan People's Hospital, Shenzhen, China. 9. Department of Neonatology, Shenzhen Bao'an Maternal and Child Health Hospital, Shenzhen, China. 10. China Medical University Children's Hospital, Taichung, Taiwan; School of Chinese Medicine, China Medical University, Taichung, Taiwan; Asia University Hospital, Asia University, Taichung, Taiwan. 11. Department of Neonatology, Shenzhen Maternity & Child Health Care Hospital, Shenzhen, China. 12. Department of Pediatrics, Section of Neonatology, Rush University Children's Hospital, Chicago, Illinois, USA. 13. Department of Neonatology, Guangdong Women and Children Hospital, Guangzhou, China. 14. Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark. 15. Department of Pediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark. 16. Hans Christian Andersen Children's Hospital, Odense, Denmark. 17. Centre for Neonatal Research and Education, University of Western Australia and King Edward Memorial Hospital, Perth, Australia. 18. Foshan Woman and Children's Hospital, Foshan, China. 19. Jinan University, Guangzhou, China.
Abstract
BACKGROUND: Transition to enteral feeding is difficult for very low-birth-weight (VLBW; ≤1500 g) infants, and optimal nutrition is important for clinical outcomes. METHOD: Data on feeding practices and short-term clinical outcomes (growth, necrotizing enterocolitis [NEC], mortality) in VLBW infants were collected from 13 neonatal intensive care units (NICUs) in 5 continents (n = 2947). Specifically, 5 NICUs in Guangdong province in China (GD), mainly using formula feeding and slow feeding advancement (n = 1366), were compared with the remaining NICUs (non-GD, n = 1581, Oceania, Europe, United States, Taiwan, Africa) using mainly human milk with faster advancement rates. RESULTS: Across NICUs, large differences were observed for time to reach full enteral feeding (TFF; 8-33 days), weight gain (5.0-14.6 g/kg/day), ∆z-scores (-0.54 to -1.64), incidence of NEC (1%-13%), and mortality (1%-18%). Adjusted for gestational age, GD units had longer TFF (26 vs 11 days), lower weight gain (8.7 vs 10.9 g/kg/day), and more days on antibiotics (17 vs 11 days; all P < .001) than non-GD units, but NEC incidence and mortality were similar. CONCLUSION: Feeding practices for VLBW infants vary markedly around the world. Use of formula and long TFF in South China was associated with more use of antibiotics and slower weight gain, but apparently not with more NEC or higher mortality. Both infant- and hospital-related factors influence feeding practices for preterm infants. Multicenter, randomized controlled trials are required to identify the optimal feeding strategy during the first weeks of life.
BACKGROUND: Transition to enteral feeding is difficult for very low-birth-weight (VLBW; ≤1500 g) infants, and optimal nutrition is important for clinical outcomes. METHOD: Data on feeding practices and short-term clinical outcomes (growth, necrotizing enterocolitis [NEC], mortality) in VLBW infants were collected from 13 neonatal intensive care units (NICUs) in 5 continents (n = 2947). Specifically, 5 NICUs in Guangdong province in China (GD), mainly using formula feeding and slow feeding advancement (n = 1366), were compared with the remaining NICUs (non-GD, n = 1581, Oceania, Europe, United States, Taiwan, Africa) using mainly human milk with faster advancement rates. RESULTS: Across NICUs, large differences were observed for time to reach full enteral feeding (TFF; 8-33 days), weight gain (5.0-14.6 g/kg/day), ∆z-scores (-0.54 to -1.64), incidence of NEC (1%-13%), and mortality (1%-18%). Adjusted for gestational age, GD units had longer TFF (26 vs 11 days), lower weight gain (8.7 vs 10.9 g/kg/day), and more days on antibiotics (17 vs 11 days; all P < .001) than non-GD units, but NEC incidence and mortality were similar. CONCLUSION: Feeding practices for VLBW infants vary markedly around the world. Use of formula and long TFF in South China was associated with more use of antibiotics and slower weight gain, but apparently not with more NEC or higher mortality. Both infant- and hospital-related factors influence feeding practices for preterm infants. Multicenter, randomized controlled trials are required to identify the optimal feeding strategy during the first weeks of life.
Authors: C Agostoni; G Buonocore; V P Carnielli; M De Curtis; D Darmaun; T Decsi; M Domellöf; N D Embleton; C Fusch; O Genzel-Boroviczeny; O Goulet; S C Kalhan; S Kolacek; B Koletzko; A Lapillonne; W Mihatsch; L Moreno; J Neu; B Poindexter; J Puntis; G Putet; J Rigo; A Riskin; B Salle; P Sauer; R Shamir; H Szajewska; P Thureen; D Turck; J B van Goudoever; E E Ziegler Journal: J Pediatr Gastroenterol Nutr Date: 2010-01 Impact factor: 2.839
Authors: Carlo Agostoni; Christian Braegger; Tamas Decsi; Sanja Kolacek; Berthold Koletzko; Kim Fleischer Michaelsen; Walter Mihatsch; Luis A Moreno; John Puntis; Raanan Shamir; Hania Szajewska; Dominique Turck; Johannes van Goudoever Journal: J Pediatr Gastroenterol Nutr Date: 2009-07 Impact factor: 2.839
Authors: Lin Wang; Xiao-Peng Zhao; Hui-Juan Liu; Li Deng; Hong Liang; Si-Qin Duan; Yi-Hui Yang; Hua-Yan Zhang Journal: Zhongguo Dang Dai Er Ke Za Zhi Date: 2022-06-15
Authors: Yanqi Li; René Liang Shen; Adejumoke I Ayede; Janet Berrington; Frank H Bloomfield; Olubunmi O Busari; Barbara E Cormack; Nicholas D Embleton; Johannes B van Goudoever; Gorm Greisen; Zhongqian He; Yan Huang; Xiaodong Li; Hung-Chih Lin; Jiaping Mei; Paula P Meier; Chuan Nie; Aloka L Patel; Per T Sangild; Thomas Skeath; Karen Simmer; Signe Uhlenfeldt; Marita de Waard; Sufen Ye; Xuqiang Ye; Chunyi Zhang; Yanna Zhu; Ping Zhou Journal: J Pediatr Date: 2020-06-14 Impact factor: 4.406
Authors: Cristina Alcon-Giner; Matthew J Dalby; Shabhonam Caim; Jennifer Ketskemety; Alex Shaw; Kathleen Sim; Melissa A E Lawson; Raymond Kiu; Charlotte Leclaire; Lisa Chalklen; Magdalena Kujawska; Suparna Mitra; Fahmina Fardus-Reid; Gustav Belteki; Katherine McColl; Jonathan R Swann; J Simon Kroll; Paul Clarke; Lindsay J Hall Journal: Cell Rep Med Date: 2020-08-25
Authors: Ping Luo; Kun Zhang; You Chen; Xiuwen Geng; Tong Wu; Li Li; Ping Zhou; Ping-Ping Jiang; Liya Ma Journal: Front Pediatr Date: 2021-12-22 Impact factor: 3.418