Limited evidence for benefits of ad libitum feeding for preterm infants

January 01, 0001

Limited evidence for benefits of ad libitum feeding for preterm infants

Clinical Question:How effective is ad libitum or demand/semi-demand feeding for preterm infants in the transition phase from intragastric tube to oral feeding?

Bottom line: Three trials reported that, compared with scheduled interval feeding, an ad libitum or demand/semi-demand feeding regimen for preterm infants allowed earlier attainment of full oral feeding and earlier hospital discharge (by about 2 to 4 days). Other trials did not confirm this finding.

Caveat: The trials were generally small and of variable methodological quality. The duration of the intervention and the duration of data collection and follow-up in most of the trials were not likely to have allowed detection of measurable effects on growth.

Context:Scheduled interval feeding of prescribed enteral volumes is current standard practice for preterm infants. Feeding preterm infants in response to their hunger and satiation cues (ad libitum or de-mand/semi demand) rather than at scheduled intervals might help in the establishment of independent oral feeding, increase nutrient intake and growth rates, and allow earlier hospital discharge.

Cochrane Systematic Review: McCormick FM et al. Ad libitum or demand/semi-demand feeding versus scheduled interval feeding for preterm infants. Cochrane Reviews 2010, Issue 2. Article No. CD005255. DOI: 10.1002/14651858.CD005255.pub3. This review contains 8 studies involving 496 participants.

Cochrane PEARLS Practical Evidence About Real Life Situations. No. 259, May 2010. .
Written by Brian R McAvoy. Published by the Cochrane Primary Care Group

Category: T. Endocrine/Metabolic/Nutritional. Keywords: feeding, preterm infants
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 28 September 2010

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Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.