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Clinical nutrition

Continuous feeding versus intermittent bolus feeding for premature infants with low birth weight: a meta-analysis of randomized controlled trials

European Journal of Clinical Nutrition volume 74, pages 775–783 (2020) Cite this article

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Abstract

Background/objectives

Clinical risks and advantages of both continuous feeding and intermittent feeding for preterm infants have been presented in previous studies. To determine the most appropriate feeding method for low-birth-weight infants, a meta-analysis was conducted.

Subjects/methods

Articles related to this topic were searched in PubMed, EMBASE, and Cochrane Library electronic database from the onset to May 2019. Heterogeneity analysis was performed with Chi-square and I2 test. Pooled analysis was based on fixed effects model, if heterogeneity between the eligible studies was negligible (I2 < 50%, P > 0.05). In contrast, a random effects model was carried out. The quality of including studies were evaluated by Cochrane assessment tool.

Results

A total of 1030 articles identified. Altogether, eight articles including 707 infants were included in final analysis based on eligibility criteria. In continuous feeding infants, time to achieving full feeds was longer (weight mean difference 0.98 (95% CI 0.26–1.71, P = 0.008) days) compared with intermittent feeding infants. Pooled analysis indicated there were no significant difference in other variables such as feeding intolerance, duration of hospitalization, days to regain birth weight, days to first successful oral feeding, duration of parenteral feeding, weight growth, length increment, head circumference growth, proven necrotizing enterocolitis, and probable necrotizing enterocolitis. In subgroup analysis for birth weight (<1000 g and >1000 g), we did not identify significant difference in time to full feeds, time to regain birth weight, and duration of hospitalization.

Conclusions

Intermittent feeding may be more beneficial for low-birth weight infants, However, well-designed studies and evidenced-based clinical practice are required to determine the most appropriate feeding method for premature infants with low birth weight.

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Author information

Authors and Affiliations

  1. Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China

    Yan Wang & Bi-ru Luo

  2. West China School of Nursing, Sichuan University, Chengdu, China

    Yan Wang & Wei Zhu

Authors
  1. Yan Wang
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  2. Wei Zhu
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  3. Bi-ru Luo
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Contributions

WZ contributed in study design, search, screening potentially eligible studies, and data extraction in this work. YW contributed in conception, screening potentially eligible studies, data extraction, data analysis, figures, and drafting the paper. BL contributed to drafting and editing the paper. All authors approved the final paper for submission.

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Correspondence to Bi-ru Luo.

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Wang, Y., Zhu, W. & Luo, Br. Continuous feeding versus intermittent bolus feeding for premature infants with low birth weight: a meta-analysis of randomized controlled trials. Eur J Clin Nutr 74, 775–783 (2020). https://doi.org/10.1038/s41430-019-0522-x

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