Improving Nutrition Outcomes for Infants < 1500 Grams With a Progressive, Evidenced-Based Enteral Feeding Protocol

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11 Scopus citations


Background: Growth is essential for very low birth weight infants. The purpose of this retrospective chart review was to evaluate the impact of a new standardized, evidenced-based feeding protocol for infants born < 1500 g in correlation with growth and clinical outcomes. Methods: Growth and nutrition data was reviewed from 2 groups of infants born < 1500 g within a level III newborn intensive care unit (NICU). Epoch 1 infants (N = 32) received care following initial implementation of a standardized enteral feeding protocol. Epoch 2 infants (N = 32) received care following aggressive modification of this initial protocol based on newly available literature that promotes earlier initiation and advancement of enteral feedings. Results: Epoch 2 infants weighed more at 36 weeks (2562 vs 2304 g) with higher discharge weight percentiles (32nd vs 15th percentile). Epoch 2 infants started and achieved full enteral feedings earlier (day of life 1 vs 4; 7 vs 22, P < 0.0001) and required less days of parenteral nutrition (5.5 vs 17.5 days, P < 0.0001), with indwelling central line for parenteral access (6 vs 17.5). There were no differences in retinopathy of prematurity (17% control vs 19% study), oxygen requirement at 36 weeks (22% epoch 1 vs 43%), necrotizing enterocolitis (3% epoch 1 vs 0%), intraventricular hemorrhage grade 3–4, periventricular leukomalacia, or death. Conclusion: In this sample of very low birth weight infants, a progressive standardized, evidence-based feeding protocol was associated with improved growth without increased risk for necrotizing enterocolitis.

Original languageEnglish (US)
Pages (from-to)647-655
Number of pages9
JournalNutrition in Clinical Practice
Issue number5
StatePublished - Oct 2018


  • clinical protocols
  • enteral nutrition
  • growth
  • infants, very low birth weight infants

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics


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