Effects of standardized feeding protocol on growth velocity and necrotizing enterocolitis in extremely low birth weight infants

Objective: To assess the effect of a standardized feeding protocol (SFP) on growth velocity (GV) and necrotizing enterocolitis (NEC) in extremely low birth weight infants. Methods: This single-study center retrospectively compared growth, nutritional, and gastrointestinal outcomes in two infant cohorts before (cohort 1; n = 145) and after (cohort 2; n = 69) SFP implementation. Results: Although weekly GV in the first 4 weeks of life did not differ between the two cohorts, median GV at 36 weeks’ post-menstrual age (PMA) was higher in cohort 2 compared with cohort 1 (26.8 g/day [24.7, 28.9] vs 24.9 g/day [22.9, 28.3], p = 0.02). The odds of NEC were lower in cohort 2 by 63% after adjusting for birth weight, small-for-gestational-age, and gender (OR = 0.38, 95% CI 0.142–0.993, p = 0.047). Conclusion: Our SFP was associated with improved GV at 36 weeks’ PMA and a lower adjusted rate of NEC.