Randomised controlled trial of trophic feeding and gut motility
Regional Neonatal
Intensive Care Unit, St James's University Hospital, Leeds
LS9 7TF
Correspondence to: Dr SJ Newell.
Accepted 13 August 1998
OBJECTIVES
To determine the effect of trophic
feeding on gastric emptying and whole gut transit time in sick preterm infants.
METHODSA randomised, controlled, prospective
study of 70 infants weighing less than 1750 g at birth, who were
receiving ventilatory support, was performed. Group TF (33 infants)
received trophic feeding from day 3 (0.5 ml/h if birthweight less than
1 kg, 1 ml/h if greater or equal to 1 kg) in addition to parenteral
nutrition until ventilatory support finished. Group C (37 infants)
received parenteral nutrition alone until ventilatory support finished. Expressed breast milk or a preterm formula were given according to
maternal preference. Gastric emptying was assessed within 24 hours of
nutritive milk feeding equal to 90 ml/kg/day, using ultrasound scans to
measure the reduction in the gastric antral cross sectional area after
a feed. Whole gut motility was assessed at both 3 and 6 weeks of age by
measuring the whole gut transit time (WGTT) of the marker carmine red.
RESULTSThere was no significant difference
between groups in their gastric half emptying time, median difference
(95% confidence interval) 2.6 (
5.9, 13.9) minutes. The WGTT was
significantly faster (p<0.05) in group TF at both 3 and 6 weeks;
median difference 13 (47, 0.1) and 12.5 (44, 0.5)
hours, respectively.
CONCLUSIONSTrophic feeding enhances whole
gut motility but not gastric emptying. This effect could subsequently
improve milk tolerance in sick preterm infants.
© 1999 by Archives of Disease in Childhood
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