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  • Three hourly feeds...

Three hourly feeds decrease hypoglycemia risk and feed intolerance in very low birthweight neonates

Dr. Nandita MohanBy Dr. Nandita MohanPublished On 2022-01-28T09:00:47+05:30  |  Updated On 2022-01-28T09:00:52+05:30
Three hourly feeds decrease hypoglycemia risk and feed intolerance in very low birthweight neonates

Researchers have found in a new study that three hourly feeding does not increase the risk of hypoglycemia, necrotizing enterocolitis or feed intolerance when compared to two hourly feeding in very low birthweight neonates. The study has been published in Indian Pediatrics Journal. Feeding of very low birthweight (VLBW) infants (1000-1500 g) is relatively difficult...

Researchers have found in a new study  that three hourly feeding does not increase the risk of hypoglycemia, necrotizing enterocolitis or feed intolerance when compared to two hourly feeding in very low birthweight neonates. The study has been published in Indian Pediatrics Journal.

Feeding of very low birthweight (VLBW) infants (1000-1500 g) is relatively difficult because majority of them are born with inadequate feeding skills, have feed intolerance, and are at an increased risk of necrotizing enterocolitis (NEC). Early initiation of enteral feeding is preferred for preterm VLBW babies with mothers own milk for less NEC and better neurodevelopment outcomes and preventing gastric atrophy and improving gut motility and reaching full feeds early.

There is no consensus regarding the feeding interval in very low birth weight (VLBW) babies. If 2-hourly feeding schedule is feasible without increasing harm to the neonate, the nursing time consumed in the feeding of VLBW babies can be reduced.

Therefore, ANITA YADAV and colleagues from the Neonatal Division, Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi, India conducted the present study to assess whether 3-hourly feeding is non-inferior to 2-hourly feeding with respect to time to reach full feeds in VLBW neonates.

The authors carried out an open-label, randomized controlled trial including a total of 350 neonates weighing between 1000 to 1500 grams, in whom feed could be started within 96 hours of life randomized to either 2-hourly or 3-hourly feeding schedule.

The results showed that –

  1. The primary outcome of time to achieve full enteral feed was comparable in the two feeding schedule groups (median 5 days IQR 4-6 days in both groups; P=0.665).
  2. Among the secondary outcomes, there were no significant differences in incidence of hypoglycemia (RR 0.86; 95% CI: 0.29-2.5) feed intolerance (RR 1.08: 95%CI: 0.5-2.3), and necrotizing enterocolitis (RR 0.8; 95% CI: 0.22-2.3) in both the groups.

Therefore, the authors concluded that "three-hourly feeding in very low birthweight babies does not increase the time to achieve full enteral feeds or increase the incidence of feed intolerance, hypoglycemia and NEC."


Three hourly feeds hypoglycemia feed intolerance necrotizing enterocolitis low birthweight infants Indian Pediatrics 
Source : Indian Pediatrics Journal
Dr. Nandita Mohan
Dr. Nandita Mohan

    Dr. Nandita Mohan is a practicing pediatric dentist with more than 5 years of clinical work experience. Along with this, she is equally interested in keeping herself up to date about the latest developments in the field of medicine and dentistry which is the driving force for her to be in association with Medical Dialogues. She also has her name attached with many publications; both national and international. She has pursued her BDS from Rajiv Gandhi University of Health Sciences, Bangalore and later went to enter her dream specialty (MDS) in the Department of Pedodontics and Preventive Dentistry from Pt. B.D. Sharma University of Health Sciences. Through all the years of experience, her core interest in learning something new has never stopped.

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