Time to full enteral feeding for very low-birth-weight infants varies markedly among hospitals worldwide but may not be associated with incidence of necrotizing enterocolitis: The NEOMUNE-NeoNutriNet Cohort Study

Marita de Waard; Yanqi Li; Yanna Zhu; Adejumoke I Ayede; Janet Berrington; Frank H Bloomfield; Olubunmi O Busari; Barbara E Cormack; Nicholas D Embleton; Johannes B van Goudoever; Gorm Greisen; Zhongqian He; Yan Huang; Xiaodong Li; Hung-Chih Lin; Jiaping Mei; Paula P Meier; Chuan Nie; Aloka L Patel; Christian Ritz; Per Torp Sangild; Thomas Skeath; Karen Simmer; Olukemi O Tongo; Signe S Uhlenfeldt; Sufen Ye; Xuqiang Ye; Chunyi Zhang; Ping Zhou

doi:10.1002/jpen.1466

Time to full enteral feeding for very low-birth-weight infants varies markedly among hospitals worldwide but may not be associated with incidence of necrotizing enterocolitis: The NEOMUNE-NeoNutriNet Cohort Study

Marita de Waard, Yanqi Li, Yanna Zhu, Adejumoke I Ayede, Janet Berrington, Frank H Bloomfield, Olubunmi O Busari, Barbara E Cormack, Nicholas D Embleton, Johannes B van Goudoever, Gorm Greisen, Zhongqian He, Yan Huang, Xiaodong Li, Hung-Chih Lin, Jiaping Mei, Paula P Meier, Chuan Nie, Aloka L Patel, Christian RitzPer Torp Sangild, Thomas Skeath, Karen Simmer, Olukemi O Tongo, Signe S Uhlenfeldt, Sufen Ye, Xuqiang Ye, Chunyi Zhang, Ping Zhou

10 Citations (Scopus)

Abstract

Background: Transition to enteral feeding is difficult for very low-birth-weight (VLBW; ≤1500 g) infants, and optimal nutrition is important for clinical outcomes. Method: Data on feeding practices and short-term clinical outcomes (growth, necrotizing enterocolitis [NEC], mortality) in VLBW infants were collected from 13 neonatal intensive care units (NICUs) in 5 continents (n = 2947). Specifically, 5 NICUs in Guangdong province in China (GD), mainly using formula feeding and slow feeding advancement (n = 1366), were compared with the remaining NICUs (non-GD, n = 1581, Oceania, Europe, United States, Taiwan, Africa) using mainly human milk with faster advancement rates. Results: Across NICUs, large differences were observed for time to reach full enteral feeding (TFF; 8–33 days), weight gain (5.0–14.6 g/kg/day), ∆z-scores (−0.54 to −1.64), incidence of NEC (1%–13%), and mortality (1%–18%). Adjusted for gestational age, GD units had longer TFF (26 vs 11 days), lower weight gain (8.7 vs 10.9 g/kg/day), and more days on antibiotics (17 vs 11 days; all P <.001) than non-GD units, but NEC incidence and mortality were similar. Conclusion: Feeding practices for VLBW infants vary markedly around the world. Use of formula and long TFF in South China was associated with more use of antibiotics and slower weight gain, but apparently not with more NEC or higher mortality. Both infant- and hospital-related factors influence feeding practices for preterm infants. Multicenter, randomized controlled trials are required to identify the optimal feeding strategy during the first weeks of life.

Original language	English
Journal	Journal of Parenteral and Enteral Nutrition
Volume	43
Issue number	5
Pages (from-to)	658-667
ISSN	0148-6071
DOIs	https://doi.org/10.1002/jpen.1466
Publication status	Published - Jul 2019

Keywords

Faculty of Science
Antibiotics
Formula
Growth
Milk
NEC
Parenteral
Preterm infants

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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de Waard, M., Li, Y., Zhu, Y., Ayede, A. I., Berrington, J., Bloomfield, F. H., Busari, O. O., Cormack, B. E., Embleton, N. D., van Goudoever, J. B., Greisen, G., He, Z., Huang, Y., Li, X., Lin, H.-C., Mei, J., Meier, P. P., Nie, C., Patel, A. L., ... Zhou, P. (2019). Time to full enteral feeding for very low-birth-weight infants varies markedly among hospitals worldwide but may not be associated with incidence of necrotizing enterocolitis: The NEOMUNE-NeoNutriNet Cohort Study. Journal of Parenteral and Enteral Nutrition, 43(5), 658-667. https://doi.org/10.1002/jpen.1466

Time to full enteral feeding for very low-birth-weight infants varies markedly among hospitals worldwide but may not be associated with incidence of necrotizing enterocolitis: The NEOMUNE-NeoNutriNet Cohort Study. / de Waard, Marita; Li, Yanqi; Zhu, Yanna et al.
In: Journal of Parenteral and Enteral Nutrition, Vol. 43, No. 5, 07.2019, p. 658-667.

Research output: Contribution to journal › Journal article › Research › peer-review

de Waard, M, Li, Y, Zhu, Y, Ayede, AI, Berrington, J, Bloomfield, FH, Busari, OO, Cormack, BE, Embleton, ND, van Goudoever, JB, Greisen, G, He, Z, Huang, Y, Li, X, Lin, H-C, Mei, J, Meier, PP, Nie, C, Patel, AL, Ritz, C, Sangild, PT, Skeath, T, Simmer, K, Tongo, OO, Uhlenfeldt, SS, Ye, S, Ye, X, Zhang, C & Zhou, P 2019, 'Time to full enteral feeding for very low-birth-weight infants varies markedly among hospitals worldwide but may not be associated with incidence of necrotizing enterocolitis: The NEOMUNE-NeoNutriNet Cohort Study', Journal of Parenteral and Enteral Nutrition, vol. 43, no. 5, pp. 658-667. https://doi.org/10.1002/jpen.1466

de Waard M, Li Y, Zhu Y, Ayede AI, Berrington J, Bloomfield FH et al. Time to full enteral feeding for very low-birth-weight infants varies markedly among hospitals worldwide but may not be associated with incidence of necrotizing enterocolitis: The NEOMUNE-NeoNutriNet Cohort Study. Journal of Parenteral and Enteral Nutrition. 2019 Jul;43(5):658-667. doi: 10.1002/jpen.1466

@article{28d8b82fae7c403598e495ca30584338,

title = "Time to full enteral feeding for very low-birth-weight infants varies markedly among hospitals worldwide but may not be associated with incidence of necrotizing enterocolitis: The NEOMUNE-NeoNutriNet Cohort Study",

abstract = "Background: Transition to enteral feeding is difficult for very low-birth-weight (VLBW; ≤1500 g) infants, and optimal nutrition is important for clinical outcomes. Method: Data on feeding practices and short-term clinical outcomes (growth, necrotizing enterocolitis [NEC], mortality) in VLBW infants were collected from 13 neonatal intensive care units (NICUs) in 5 continents (n = 2947). Specifically, 5 NICUs in Guangdong province in China (GD), mainly using formula feeding and slow feeding advancement (n = 1366), were compared with the remaining NICUs (non-GD, n = 1581, Oceania, Europe, United States, Taiwan, Africa) using mainly human milk with faster advancement rates. Results: Across NICUs, large differences were observed for time to reach full enteral feeding (TFF; 8–33 days), weight gain (5.0–14.6 g/kg/day), ∆z-scores (−0.54 to −1.64), incidence of NEC (1%–13%), and mortality (1%–18%). Adjusted for gestational age, GD units had longer TFF (26 vs 11 days), lower weight gain (8.7 vs 10.9 g/kg/day), and more days on antibiotics (17 vs 11 days; all P <.001) than non-GD units, but NEC incidence and mortality were similar. Conclusion: Feeding practices for VLBW infants vary markedly around the world. Use of formula and long TFF in South China was associated with more use of antibiotics and slower weight gain, but apparently not with more NEC or higher mortality. Both infant- and hospital-related factors influence feeding practices for preterm infants. Multicenter, randomized controlled trials are required to identify the optimal feeding strategy during the first weeks of life.",

keywords = "Faculty of Science, Antibiotics, Formula, Growth, Milk, NEC, Parenteral, Preterm infants",

author = "{de Waard}, Marita and Yanqi Li and Yanna Zhu and Ayede, {Adejumoke I} and Janet Berrington and Bloomfield, {Frank H} and Busari, {Olubunmi O} and Cormack, {Barbara E} and Embleton, {Nicholas D} and {van Goudoever}, {Johannes B} and Gorm Greisen and Zhongqian He and Yan Huang and Xiaodong Li and Hung-Chih Lin and Jiaping Mei and Meier, {Paula P} and Chuan Nie and Patel, {Aloka L} and Christian Ritz and Sangild, {Per Torp} and Thomas Skeath and Karen Simmer and Tongo, {Olukemi O} and Uhlenfeldt, {Signe S} and Sufen Ye and Xuqiang Ye and Chunyi Zhang and Ping Zhou",

note = "(CURIS 2018 NEXS 402) --> 2019 (Afventer endelig publicering + nyt CURIS-nr.) Publiceret online: 22.11.2018",

year = "2019",

month = jul,

doi = "10.1002/jpen.1466",

language = "English",

volume = "43",

pages = "658--667",

journal = "Journal of Parenteral and Enteral Nutrition",

issn = "0148-6071",

publisher = "SAGE Publications",

number = "5",

}

TY - JOUR

T1 - Time to full enteral feeding for very low-birth-weight infants varies markedly among hospitals worldwide but may not be associated with incidence of necrotizing enterocolitis

T2 - The NEOMUNE-NeoNutriNet Cohort Study

AU - de Waard, Marita

AU - Li, Yanqi

AU - Zhu, Yanna

AU - Ayede, Adejumoke I

AU - Berrington, Janet

AU - Bloomfield, Frank H

AU - Busari, Olubunmi O

AU - Cormack, Barbara E

AU - Embleton, Nicholas D

AU - van Goudoever, Johannes B

AU - Greisen, Gorm

AU - He, Zhongqian

AU - Huang, Yan

AU - Li, Xiaodong

AU - Lin, Hung-Chih

AU - Mei, Jiaping

AU - Meier, Paula P

AU - Nie, Chuan

AU - Patel, Aloka L

AU - Ritz, Christian

AU - Sangild, Per Torp

AU - Skeath, Thomas

AU - Simmer, Karen

AU - Tongo, Olukemi O

AU - Uhlenfeldt, Signe S

AU - Ye, Sufen

AU - Ye, Xuqiang

AU - Zhang, Chunyi

AU - Zhou, Ping

N1 - (CURIS 2018 NEXS 402) --> 2019 (Afventer endelig publicering + nyt CURIS-nr.) Publiceret online: 22.11.2018

PY - 2019/7

Y1 - 2019/7

N2 - Background: Transition to enteral feeding is difficult for very low-birth-weight (VLBW; ≤1500 g) infants, and optimal nutrition is important for clinical outcomes. Method: Data on feeding practices and short-term clinical outcomes (growth, necrotizing enterocolitis [NEC], mortality) in VLBW infants were collected from 13 neonatal intensive care units (NICUs) in 5 continents (n = 2947). Specifically, 5 NICUs in Guangdong province in China (GD), mainly using formula feeding and slow feeding advancement (n = 1366), were compared with the remaining NICUs (non-GD, n = 1581, Oceania, Europe, United States, Taiwan, Africa) using mainly human milk with faster advancement rates. Results: Across NICUs, large differences were observed for time to reach full enteral feeding (TFF; 8–33 days), weight gain (5.0–14.6 g/kg/day), ∆z-scores (−0.54 to −1.64), incidence of NEC (1%–13%), and mortality (1%–18%). Adjusted for gestational age, GD units had longer TFF (26 vs 11 days), lower weight gain (8.7 vs 10.9 g/kg/day), and more days on antibiotics (17 vs 11 days; all P <.001) than non-GD units, but NEC incidence and mortality were similar. Conclusion: Feeding practices for VLBW infants vary markedly around the world. Use of formula and long TFF in South China was associated with more use of antibiotics and slower weight gain, but apparently not with more NEC or higher mortality. Both infant- and hospital-related factors influence feeding practices for preterm infants. Multicenter, randomized controlled trials are required to identify the optimal feeding strategy during the first weeks of life.

AB - Background: Transition to enteral feeding is difficult for very low-birth-weight (VLBW; ≤1500 g) infants, and optimal nutrition is important for clinical outcomes. Method: Data on feeding practices and short-term clinical outcomes (growth, necrotizing enterocolitis [NEC], mortality) in VLBW infants were collected from 13 neonatal intensive care units (NICUs) in 5 continents (n = 2947). Specifically, 5 NICUs in Guangdong province in China (GD), mainly using formula feeding and slow feeding advancement (n = 1366), were compared with the remaining NICUs (non-GD, n = 1581, Oceania, Europe, United States, Taiwan, Africa) using mainly human milk with faster advancement rates. Results: Across NICUs, large differences were observed for time to reach full enteral feeding (TFF; 8–33 days), weight gain (5.0–14.6 g/kg/day), ∆z-scores (−0.54 to −1.64), incidence of NEC (1%–13%), and mortality (1%–18%). Adjusted for gestational age, GD units had longer TFF (26 vs 11 days), lower weight gain (8.7 vs 10.9 g/kg/day), and more days on antibiotics (17 vs 11 days; all P <.001) than non-GD units, but NEC incidence and mortality were similar. Conclusion: Feeding practices for VLBW infants vary markedly around the world. Use of formula and long TFF in South China was associated with more use of antibiotics and slower weight gain, but apparently not with more NEC or higher mortality. Both infant- and hospital-related factors influence feeding practices for preterm infants. Multicenter, randomized controlled trials are required to identify the optimal feeding strategy during the first weeks of life.

KW - Faculty of Science

KW - Antibiotics

KW - Formula

KW - Growth

KW - Milk

KW - NEC

KW - Parenteral

KW - Preterm infants

U2 - 10.1002/jpen.1466

DO - 10.1002/jpen.1466

M3 - Journal article

C2 - 30465333

SN - 0148-6071

VL - 43

SP - 658

EP - 667

JO - Journal of Parenteral and Enteral Nutrition

JF - Journal of Parenteral and Enteral Nutrition

IS - 5

ER -