Early milk feeds best for vulnerable premature babies

April 12, 2012
The study looked at the feeding of babies born five or more weeks early, who were also smaller than they should have been for their age.

(Medical Xpress) -- The way premature babies are fed in hospitals could change following the results of an Oxford University-led study.

Babies who are born premature and 'growth-restricted' would generally benefit from starting milk feeds within the first 24–48 hours after birth, the study found.

High-risk are vulnerable to severe bowel problems, which has led previously to a tendency to delay the start of milk feeds. Doctors and nurses can now be more confident in starting to feed these high-risk earlier, the researchers said.

The findings could also lead to babies being able to leave specialist care units earlier, freeing up high-dependency care cots for other sick babies to use.

The trial, the largest to date looking at the issue of feeding these high-risk premature babies, was co-ordinated by the National Perinatal Epidemiology Unit at the University of Oxford and carried out at 54 hospitals across UK and Ireland.

The research was funded by children's charity Action Medical Research with support from The Garfield Weston Foundation and is published in the journal Pediatrics.

The study looked at the feeding of babies born five or more weeks early, who were also smaller than they should have been for their age. It was led by consultant neonatologist Dr. Alison Leaf and Professor Peter Brocklehurst from the National Perinatal Epidemiology Unit.

"These babies are a challenge to feed," said Dr. Leaf, who is now an academic consultant at the National Institute for Health Research, Southampton Biomedical Research Centre. "Good nutrition and growth is very important, however their body organs, including the bowel, are immature. They often do not cope well with milk, and may develop severe bowel inflammation, a condition called necrotising enterocolitis, which can make them very ill.  

"Because of this, starting milk feeds is often delayed and early nutrition is given intravenously. This also has risks, particularly of infection and liver inflammation. Until now, nobody had tested whether it is better to start milk feeds early or to delay, so the project was designed to answer this question."

The study compared starting milk feeds early with later feeds and involved more than 400 premature babies. Half the babies started milk feeds on day 2 after birth, and the other half started on day 6. Full feeding was achieved earlier in the babies who started milk feeds on day 2. On average, these babies no longer needed an intravenous drip for feeds three days earlier than the babies starting milk feeds on day 6.

There was no difference in the number of babies experiencing severe bowel problems between those who had early feeds and those who started later.

Professor Brocklehurst, who is now Director of the Institute for Women's Health at University College, London, said: 'Early feeding appears to be better for these high risk babies. This research will enable more high-risk premature babies to be fed early, and to achieve full feeding earlier. This will reduce the need for intravenous drips and infusions.

He added: "It will also reduce the duration of occupancy of a high-dependency cot, which will free up resources for other sick babies, thus providing benefit for a wider population of sick infants."

These were vulnerable premature babies: almost half of the babies in the trial required some respiratory support, though really sick babies were not included in the trial.The great majority of the babies received their mother’s breast milk when feeding was started, rather than donor breast milk or formula.

The researchers are confident that the findings from this study can be put into effect immediately, and will result in clearer guidelines on nutrition and feeding for neonatal units across the UK and potentially worldwide.

Explore further: Formula-fed preemies at higher risk for dangerous GI condition than babies who get donor milk

Related Stories

Formula-fed preemies at higher risk for dangerous GI condition than babies who get donor milk

May 1, 2011
Extremely premature babies fed human donor milk are less likely to develop the dangerous intestinal condition necrotizing enterocolitis (NEC) than babies fed a standard premature infant formula derived from cow's milk, according ...

Researcher urges study of effects of breast pumps

July 7, 2011
(Medical Xpress) -- The widespread use of electric breast pumps by American women is fueling a "quiet revolution" in how infants receive their mothers' milk, argues Cornell nutritionist Kathleen Rasmussen in a commentary ...

Premature babies harbor fewer, but more dangerous microbe types

December 8, 2011
One of the most comprehensive studies to date of the microbes that are found in extremely low-birthweight infants found that hard-to-treat Candida fungus is often present, as well as some harmful bacteria and parasites.

New infant formula ingredients boost babies' immunity by feeding their gut bacteria

February 29, 2012
Adding prebiotic ingredients to infant formula helps colonize the newborn's gut with a stable population of beneficial bacteria, and probiotics enhance immunity in formula-fed infants, two University of Illinois studies report.

Recommended for you

To reduce postoperative pain, consider sleep—and caffeine

August 18, 2017
Sleep is essential for good mental and physical health, and chronic insufficient sleep increases the risk for several chronic health problems.

Despite benefits, half of parents against later school start times

August 18, 2017
Leading pediatrics and sleep associations agree: Teens shouldn't start school so early.

Doctors exploring how to prescribe income security

August 18, 2017
Physicians at St. Michael's Hospital are studying how full-time income support workers hired by health-care clinics can help vulnerable patients or those living in poverty improve their finances and their health.

Schoolchildren who use e-cigarettes are more likely to try tobacco

August 17, 2017
Vaping - or the use of e-cigarettes - is widely accepted as a safer option for people who are already smoking.

Federal snack program does not yield expected impacts, researchers find

August 17, 2017
A well-intentioned government regulation designed to offer healthier options in school vending machines has failed to instill better snacking habits in a sample of schools in Appalachian Virginia, according to a study by ...

Study shows cigarette makers shifted stance on nicotine patches, gum

August 17, 2017
The use of nicotine patches, gum, lozenges, inhalers or nasal sprays—together called "nicotine replacement therapy," or NRT—came into play in 1984 as prescription medicine, which when combined with counseling, helped ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.