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Am J Perinatol. 2019 Jun 4. doi: 10.1055/s-0039-1691767. [Epub ahead of print]

Two-Hourly versus Three-Hourly Feeding in Very Low-Birth-Weight Infants: A Systematic Review and Meta-Analysis.

Author information

1
Division of Neonatology, Department of Pediatrics, Princess Nourah Bint Abdulrahman University, King Abdullah bin Abdulaziz University Hospital, Riyadh, Saudi Arabia.
2
Department of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton, Ontario, Canada.

Abstract

OBJECTIVE:

 To systematically review and meta-analyze the benefits and side effects of 3-hourly versus 2-hourly feeding intervals in very low-birth-weight (VLBW) infants.

STUDY DESIGN:

 Database search include PubMed and Cochrane CENTRAL databases from inception until March 3, 2019. The author extracted the data from included studies and used Cochrane-GRADE approach to assess the quality of the evidence.

RESULTS:

 Seven studies-four randomized controlled trials (RCTs) and three observational studies-involving 952 infants were included in the review. The pooled analyses of RCTs showed no significant differences in the outcomes: time to reach full enteral feeding, necrotizing enterocolitis, feed intolerance, and hypoglycemia. Infants fed 3-hourly regain birth weight earlier than infants fed 2-hourly (3 RCTs; 350 participants; mean difference [95% confidence interval] -1.12 [-2.16 to -0.08]; I2 = 0%; p = 0.04). The evidence was downgraded to low quality due to risk of bias and imprecision for all outcomes. Two studies found a subgroup of infants, younger and smaller, reach full enteral feeds earlier when fed 2-hourly compared with 3-hourly.

CONCLUSION:

 Low-quality evidence suggests feeding 3-hourly is comparable to 2-hourly feeding in VLBW infants. However, extremely low-birth-weight infants reach full enteral feeds earlier when fed 2-hourly compared with 3-hourly. Further, sufficient powered trials are needed.

PMID:
31163479
DOI:
10.1055/s-0039-1691767

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