Please use this identifier to cite or link to this item:
Title: Controlled Trial of Two Incremental Milk Feeding Rates in Preterm Infants
Authors: Dorling, J
Abbott, J
Berrington, J
Bosiak, B
Bowler, U
Boyle, E
Embleton, N
Hewer, O
Johnson, S
Juszczak, E
Leaf, A
Linsell, L
McCormick, K
McGuire, W
Omar, O
Partlett, C
Patel, M
Roberts, T
Stenson, B
Townend, J
First Published: 2019
Publisher: Massachusetts Medical Society
Citation: New England Journal of Medicine, 2019, In Press
Abstract: Background Observational data have shown that slowly advancing enteral feeds in preterm infants is associated with reduced risk for necrotizing enterocolitis but increased risk for late onset sepsis. However, randomized trial data are limited. Methods We randomized very preterm or very low birthweight (VLBW) infants to daily milk increments of 30 or 18ml/kg/day until reaching full feeds. The primary outcome was survival without moderate or severe neurodevelopmental disability at 24 months. Secondary outcomes included components of the primary outcome, confirmed or suspected late onset sepsis, necrotizing enterocolitis and cerebral palsy. Results Among 2,804 infants randomized, the primary outcome was classifiable in 1224 (87.4%) of infants allocated to faster and 1246 (88.7%) to slower increments. Survival without moderate or severe neurodevelopmental disability at 24 months occurred in 802/1224 (65.5%) of infants allocated to faster and 848/1246 (68.1%) allocated to slower increments (adjusted risk ratio (RR), 0.96; 95% Confidence interval (CI), 0.92 to 1.01; p=0.16). Late onset sepsis occurred in 414/1389 (29.8%) of the faster and 434/1397 (31.1%) of the slower increment group (adjusted RR 0.96; 95% CI 0.86 to 1.07). Necrotizing enterocolitis occurred in 70/1394 (5.0%) of the faster and 78/1399 (5.6 %) of the slower group (adjusted RR 0.88; 95% CI, 0.68 to 1.16). Conclusions There was no significant difference in survival without moderate or severe neurodevelopmental disability at 24 months in very preterm or VLBW infants with a strategy of advancing milk feeds in daily increments of 30ml/kg versus 18ml/kg. (Funded by the Health Technology Assessment Programme of the National Institute for Health Research; ISRCTN registration number ISRCTN76463425).
ISSN: 0028-4793
Links: TBA
Embargo on file until: 1-Jan-10000
Version: Post-print
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © 2019, Massachusetts Medical Society. Deposited with reference to the publisher’s open access archiving policy. (
Description: The file associated with this record is under embargo until 6 months after publication, in accordance with the publisher's self-archiving policy. The full text may be available through the publisher links provided above.
Appears in Collections:Published Articles, Dept. of Health Sciences

Files in This Item:
File Description SizeFormat 
Dorling-18-16654-Text.pdfPost-review (final submitted author manuscript)401.28 kBAdobe PDFView/Open

Items in LRA are protected by copyright, with all rights reserved, unless otherwise indicated.