Comparison of initiating total enteral feeding versus incremental feeding since birth in stable very low birth weight and small for gestational age babies at or above 32 weeks of gestation on duration of hospital stay

Very low birth weight refers to babies with birth weight in between 1000 to 1499gm. Initiation of enteral feeds for very-low-birth weight (VLBW) infants is often delayed for several days due to concerns about feeding intolerance and necrotizing enterocolitis (NEC). The intestine of small for gestational age neonate has reduced weight, length, wall thickness, villous weight and crypt depth. Pathophysiology of fetal adaptation to chronic hypoxia involves preferential shunting of blood to the brain at the expense of the splanchnic circulation. Earlier studies had very samples from the SGA populations. Early introduction of enteral feeds resulted in early achievement of full feeds and doesn’t appear to increase the risk of NEC. This delay diminishes the functional adaptation of the gastrointestinal tract and may prolong the duration of parenteral nutrition with its attendant infectious and metabolic risks. Early introduction and rapid advancement of enteral feeding in preterm infants improves gut maturity and thus reduces the risk of NEC. So the above study shall test the hypothesis that, early total enteral feeding in these group of babies shall lead to shorter duration of hospital stay and earlier discharge.