Colm P Travers1, Timothy Wang2, Ariel A Salas3, Erin Schofield4, Madeline Dills5, Deborah Laney3, Aaron Yee6, Anisha Bhatia3, Lindy Winter3, Namasivayam Ambalavanan3, Waldemar A Carlo3. 1. Department of Pediatrics, Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL. Electronic address: ctravers@peds.uab.edu. 2. Department of Pediatrics, Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL; Department of Pediatrics, Division of Neonatology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. 3. Department of Pediatrics, Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL. 4. Department of Pediatrics, Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL; Department of Pediatrics, Division of Neonatology, University of Maryland, Baltimore, MD. 5. Department of Pediatrics, Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL; Department of Surgery, Louisiana State University Health Sciences Center, New Orleans, LA. 6. Department of Pediatrics, Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL; Department of Pediatrics, Division of Neonatology, Nemours Alfred I. duPont Hospital for Children, Wilmington, DE.
Abstract
OBJECTIVE: To determine whether higher-volume feedings improve postnatal growth among infants born very preterm. STUDY DESIGN: Randomized clinical trial with 1:1 parallel allocation conducted from January 2015 to June 2018 in a single academic medical center in the US. In total, 224 infants with a birth weight1001-2500 g born at <32 weeks of gestation were randomized to higher-volume (180-200 mL/kg/d) or usual-volume (140-160 mL/kg/d) feedings after establishing full enteral feedings (≥120 mL/kg/d). The primary outcome was growth velocity (g/kg/d) from randomization to study completion at 36 weeks of postmenstrual age or hospital discharge if earlier. RESULTS:Growth velocity increased among infants in the higher-volume group compared with the usual-volume group (mean [SD], 20.5 [4.5] vs 17.9 [4.5] g/kg/d; P < .001). At study completion, all measurements were higher among infants in the higher-volume group compared with the usual-volume group: weight (2365 [324] g, z score -0.60 [0.73] vs 2200 [308] g, z score -0.94 [0.71]; P < .001); head circumference (31.9 [1.3] cm, z score -0.30 [0.91] vs 31.4 [1.3] cm, z score -0.53 [0.84]; P = .01); length (44.9 [2.1] cm, z score -0.68 [0.88] vs 44.4 [2.0], z score -0.83 [0.84]; P = .04); and mid-arm circumference (8.8 [0.8] cm vs 8.4 [0.8] cm; P = .002). Bronchopulmonary dysplasia, patent ductus arteriosus, necrotizing enterocolitis, or other adverse outcomes did not differ between groups. CONCLUSIONS: In infants born very preterm weighing 1001-2500 g at birth, higher-volume feedings increased growth velocity, weight, head circumference, length, and mid-arm circumference compared with usual-volume feedings without adverse effects. TRIAL REGISTRATION: ClinicalTrials.gov; NCT02377050.
RCT Entities:
OBJECTIVE: To determine whether higher-volume feedings improve postnatal growth among infants born very preterm. STUDY DESIGN: Randomized clinical trial with 1:1 parallel allocation conducted from January 2015 to June 2018 in a single academic medical center in the US. In total, 224 infants with a birth weight 1001-2500 g born at <32 weeks of gestation were randomized to higher-volume (180-200 mL/kg/d) or usual-volume (140-160 mL/kg/d) feedings after establishing full enteral feedings (≥120 mL/kg/d). The primary outcome was growth velocity (g/kg/d) from randomization to study completion at 36 weeks of postmenstrual age or hospital discharge if earlier. RESULTS: Growth velocity increased among infants in the higher-volume group compared with the usual-volume group (mean [SD], 20.5 [4.5] vs 17.9 [4.5] g/kg/d; P < .001). At study completion, all measurements were higher among infants in the higher-volume group compared with the usual-volume group: weight (2365 [324] g, z score -0.60 [0.73] vs 2200 [308] g, z score -0.94 [0.71]; P < .001); head circumference (31.9 [1.3] cm, z score -0.30 [0.91] vs 31.4 [1.3] cm, z score -0.53 [0.84]; P = .01); length (44.9 [2.1] cm, z score -0.68 [0.88] vs 44.4 [2.0], z score -0.83 [0.84]; P = .04); and mid-arm circumference (8.8 [0.8] cm vs 8.4 [0.8] cm; P = .002). Bronchopulmonary dysplasia, patent ductus arteriosus, necrotizing enterocolitis, or other adverse outcomes did not differ between groups. CONCLUSIONS: In infants born very preterm weighing 1001-2500 g at birth, higher-volume feedings increased growth velocity, weight, head circumference, length, and mid-arm circumference compared with usual-volume feedings without adverse effects. TRIAL REGISTRATION: ClinicalTrials.gov; NCT02377050.
Authors: Ariel A Salas; Colm P Travers; Maggie L Jerome; Paula Chandler-Laney; Waldemar A Carlo Journal: J Pediatr Date: 2020-11-25 Impact factor: 4.406
Authors: Kaitlyn Oliphant; Mehneez Ali; Mark D'Souza; Patrick D Hughes; Dinanath Sulakhe; Annie Z Wang; Bingqing Xie; Rummanu Yeasin; Michael E Msall; Bree Andrews; Erika C Claud Journal: Gut Microbes Date: 2021 Jan-Dec