In resource limited areas complete enteral feed in stable very low birth weight infants (1000–1500 g) started within 24 h of life can improve nutritional outcome

Objective: To evaluate feasibility of complete enteral feed (CEF) in stable very low birth weight neonates weighing 1000-1500 g. Subjects and interventions: One hundred and three stable very low birth weight (vlbw) neonates (1000-1500 g) irrespective of gestational age (GA) were randomized to receive either CEF with expressed breast milk (EBM) (n = 51) or minimal enteral feed (MEF) supplemented with intravenous fluid (IVF). (MEF) (n = 52). Feed volume was increased progressively. Primary outcome measures were feed intolerance (FI) and necrotizing enterocolitis (NEC) in first 21 days of life or discharge from NICU, whichever was earlier. Secondary outcome measures were the time taken to reach calorie intake of 110 kcal/kg/D and regain of birthweight. Results: FI was observed in n = 12 (23.53%) in CEF group versus n = 6 (11.53%) in MEF group (p = 0.1264). NEC was observed in 4 (7.8%) in CEF group versus 1(1.9%) in MEF group (p = 0.16) and results were comparable in both groups. Birthweight regain (10.6 +/- 1.6 days versus 11.8 +/- 1.6 days, p = 0.038), NICU discharge (11.7 +/- 2.6 days versus 13.0 +/- 3.45 days, p = 0.038) and time to reach 110 kcal/kg/day (9.571 +/- 1.458 days versus 10.833 +/- 1.655 days, p = 0.001) were significantly earlier in CEF compared to MEF group. Conclusion: Complete enteral feeds started within 24 h of life is feasible in vlbw neonates.