A Three-Arm, Parallel-Group Randomized Controlled Trial Comparing Continuous, Standard Bolus, and Accelerated Continuous Enteral Feeding in Neonates with Birth Weight less than 1.8 kg

Low birth weight neonates often experience feeding intolerance and delayed achievement of full enteral nutrition due to gastrointestinal immaturity. Various enteral feeding strategies such as continuous and bolus feeding are practiced, but there is limited evidence regarding the optimal feeding method for neonates weighing less than 1.8 kg.

This study is a single-center, randomized controlled trial conducted in a tertiary care neonatal intensive care unit to compare continuous enteral feeding, standard bolus feeding, and accelerated continuous feeding in neonates weighing less than 1.8 kg. Eligible, hemodynamically stable neonates will be randomized into one of the three feeding groups. Enteral feeds will be initiated and advanced as per predefined protocols using expressed breast milk.

The primary outcome is the time taken to achieve full enteral feeds (150 ml/kg/day). Secondary outcomes include growth parameters, incidence of necrotizing enterocolitis, apnea, sepsis, and length of hospital stay. The findings of this study aim to identify the safest and most effective enteral feeding strategy for low birth weight neonates and guide evidence-based clinical practice.