Two-hourly vs Three-hourly Feeding in Very Low Birthweight Neonates: A Randomized Controlled Trial

Abstract

Background: There is no consensus regarding the feeding interval in very low birth weight (VLBW) babies. If 2-hourly feeding schedule is feasible without increasing harm to the neonate, the nursing time consumed in the feeding of VLBW babies can be reduced.

Objective: To study whether 3-hourly feeding is non-inferior to 2-hourly feeding with respect to time to reach full feeds in VLBW neonates.

Design: Open-label, randomized controlled trial.

Subjects: 350 Neonates weighing between 1000 to 1500 grams, in whom feed could be started within 96 hours of life randomized to either 2-hourly or 3-hourly feeding schedule.

Primary outcome: Time to achieve full enteral feed.

Results: The primary outcome of time to achieve full enteral feed was comparable in the two feeding schedule groups (median 5 days IQR 4-6 days in both groups; P=0.665). Among the secondary outcomes, there were no significant differences in incidence of hypoglycemia (RR 0.86; 95% CI: 0.29-2.5) feed intolerance (RR 1.08: 95% CI: 0.5-2.3), and necrotizing enterocolitis (RR 0.8; 95% CI: 0.22-2.3) in both the groups.

Conclusions: Three hourly feeding does not increase the risk of hypoglycemia, necrotizing enterocolitis or feed intolerance.