G572(P) Evidence for feeding practices in very low birthweight infants in sub-saharan africa and implications for future research: an overview of systematic reviews

Aim To review the evidence available for optimising feeding of VLBW infants in sub Saharan Africa (sSA) and to identify areas for future research. Methods We did a comprehensive literature search in Cochrane Database of Systematic reviews, EMBASE, PUBMED and CINAHL (July 2019). The key search terms were: very low birthweight AND (enteral feeding or enteral nutrition) AND (systematic review or meta-analysis). Systematic reviews and meta-analyses of randomised and quasi-randomised controlled trials of interventions which focused on the effect of four ‘basic’ feeding practices: when to start enteral feeds, what to feed when EBM is insufficient or unavailable, how to feed and how to advance feeds on weight gain during hospital stay and time to achieve full enteral feeds were eligible for inclusion. We assessed the quality of each review using the AMSTAR (A Measurement Tool to Assess systematic Reviews) tool. Results We included 8 systematic reviews comprising of 10 comparisons, all were of high methodological quality and assessed what to feed, how to feed and how to advance feeds. There were no reviews which examined the effect of early trophic feeding (at age Conclusion There is a need for pragmatic trials in preterm feeding in sub-Saharan Africa that would consider inexpensive, low technology and sustainable interventions in the area of when to start feeds, what to feed, absolute volumes, modes of feeding and use of fortification. There is evidence that rapid advancement of feeds will confer benefits to babies in sSA where fortification with extra protein or calories might not be feasible, affordable or available.