Analysis Of Enteral Feeding In 57 Very Low Birth Weight Infants

Objective:To understand more about the enteral feeding and to improve the feeding strategy for very low birth weight infant(VLBWI) in our hospital by analyze enteral feeding in 57 VLBWI.Methods:Clinical data of 57 VLBWI admission form January 2013 to December 2014 were Collected in neonatle division of our hospital. According to the initial enteral feeding within 2 days or after 2 days after birth, sufficient or insufficient enteral feeding in 28 days after birth, all cases were divided into two groups, early feeding and postponed feeding, full feeding and non-full feeding, respectively. Comparison of general data, perinatal complication, enteral feeding and it’s influence was conducted between each two groups. Logistic analysis was conducted to determine the high risk factors for postpone feeding and non-full feeding.Results:(1) Among 57 VLBWI,22 were males,35 were females. The average birth weight was 1235.00±26.35g. The average gestational age was 31.29±0.310 weeks. (2) Feeding intolerance was found in 24 VLBWI with incidence of 42.1%.3 cases complicated with necrotizing enterocolitis of newborn (NEC). (3) Initial feeding within 2 days after birth was performed in 31 infants with 26 infants were postponed initial feeding after 2 days. The average age of initial feeding was 3.63±0.493 days. Compared to postponed feeding group, the early feeding group had a larger GA and birth weight, lower incidence of asphyxia, bronchopulmonay dysplysia, earlier restoring to birth weight, shorter hospitalization and parenteral nutrition, less hospitalization cost. No significant difference of incidence of pregnancy hyperternsion, preeclampsia, gestatjional diabetes mellitus, premature rupture of membran, antepartum infection, fetal distress, nosocomial infection, septicemia, NEC, cholestasis between early feeding and postponed feeding groups. The high risk factor for delay initial feeding was ventilation within 2 days after birth. (4) In these cases, the shortest time to achieve full feeding was 12 days, with the longest time was 85 days. The median was 35 days.19 cases reached full feeding within 28 days after birth.38 cases failed. Compared to non-full feeding group, the group of full feeding had a larger GA and birth weight, less days of parenteral nutrition, lower lever of serum bile acid. No difference of direct bilirubinemia level, incidence of SGA, ventilation support, aminophyline supplement, nosocomial infection, septicemia, cholestasis between two groups. High risk factors for non-full feeding within 28 days after birth were postponed initial feeding, asphyxia, feeding intolerance.Conclusions:(1) The risk factors associated with the postponed initial enteral feeding were mechanical ventilation within 2 days after birth. (2) Postponed feeding, feeding intolerance and asphyxia are high risk factors for realizing full feeding. Initiate feeding earlier, prevent asphyxia, treat feeding intolerance should be strategy to realize full feeding.