• Clinical effectiveness of hydrolyzed protein preterm formula in prevention of feeding intolerance in preterm very low birth weight infants 

Clinical effectiveness of hydrolyzed protein preterm formula in prevention of feeding intolerance in preterm very low birth weight infants 

PERINATOLOGIYA I PEDIATRIYA.2016.1(65):88-94;doi 10.15574/PP.2016.65.88 
 

Clinical effectiveness of hydrolyzed protein preterm formula in prevention of feeding intolerance in preterm very low birth weight infants 
 

Dobryanskyy D., Novikova O., Borysiuk O., Dubrovna Y., Salabay Z.

Danylo Halytsky Lviv National Medical University, Lviv, Ukraine

Lviv Regional Clinical Hospital, Lviv, Ukraine 
 

The aim of this open randomized study was to investigate whether hydrolyzed protein preterm infant formula improves early feeding tolerance compared with standard preterm infant formula. 
 

Patients and methods. The all very low birth weight infants (n=69) admitted to the NICU were randomly assigned to receive hydrolyzed protein preterm infant formula (3.1 g of protein/100 ml) or standard preterm infant formula if human milk was not available. They were fed with the predetermined formula until the full enteral volume was reached. Nine infants who died were excluded. Primary study outcome was the infant's age in which full enteral volume (150 mL/kg birth weight/d) was achieved. Number and duration of episodes of enteral volume reduction or withholding and postnatal growth rates were compared as well. Daily volume was advanced by 10–20 ml/kg according to the standard protocol. Preprandial gastric residuals up to 50% of the previous feed were tolerated if it was neither increase of abdominal girth >2 cm nor vomiting; otherwise, feedings were reduced or withheld. 
 

Results. Thirty five and 25 (hydrolyzed protein preterm infant formula vs standard preterm infant formula) infants were enrolled into final analysis. Formula bolus feeding was started in all infants on the first day of life. There was no significant difference with regard to birth weight, gestational age, and need for resuscitation at birth. The infant's age in which full enteral volume was reached was lower with hydrolyzed protein preterm infant formula feeding (12.46 [5.2] vs 14.4 [6.76] days) but the difference was not statistically significant (p=0.21). Any failure to increase daily volume was seen in 20 (57%) newborns fed with hydrolyzed protein preterm infant formula and in 15 (60%) control infants (p>0.05), but feeding was withheld almost 2 times more often in infants fed with standard preterm infant formula as compared to hydrolyzed protein preterm infant formula (36% vs 17%; p<0.1). Enteral volume was reduced of withheld for the similar period of time. The patterns of postnatal physical growth were identical in the groups and there was no difference in any clinically significant outcomes. 
 

Conclusions. Hydrolyzed protein preterm infant formula can improve the feeding tolerance and enable a more rapid establishment of full enteral feeding in very low birth weight infants compared with standard preterm infant formula. There is no growth concerns of very low birth weight infants fed with the hydrolyzed protein preterm infant formula containing high concentration of serum protein. 
 

Key words: hydrolyzed protein preterm formula, enteral feeding intolerance, preterm very low birth weight infants. 
 

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