EFFECTS OF EARLY VERSUS LATE TROPHIC FEEDING IN PRE-TERM LOW BIRTH WEIGHT NEONATES

Abstract

Background: Trophic feeding refers to minimal enteral nutrition administered to stimulate gut maturation in preterm neonates. The timing of trophic feeding initiation may influence critical outcomes such as feeding tolerance, weight gain, and duration of hospitalization.

Objective: To compare the outcomes in preterm low birth weight neonates receiving early trophic feeding (initiated within 24 hours of life) versus late trophic feeding (initiated after 72 hours of life).

Methods: A randomized controlled trial was conducted in the NICU of Fauji Foundation Hospital, Rawalpindi from March 2025 to 15 June  2025. A total of 220 neonates (<34 weeks gestation, birth weight <2500g) were randomly assigned to early (Group A) or late (Group B) trophic feeding groups. Key outcomes included duration of parenteral nutrition, weight gain at discharge, duration of hospitalization, and feeding intolerance. Data were analyzed using SPSS version 21.

Results: A total of 220 preterm low birth weight neonates were randomized into early (within 24 hours) and late (after 72 hours) trophic feeding groups. Infants in the early feeding group showed significantly greater weight gain (580 ± 85 g vs. 490 ± 95 g; p = 0.001), shorter duration of parenteral nutrition (9.2 ± 4.6 vs. 14.1 ± 6.4 days; p < 0.001), and reduced hospital stay (12.1 ± 8.6 vs. 21.1 ± 9.1 days; p < 0.001). Abdominal distension was less common in the early group (9.1% vs. 20.0%; p = 0.02), while vomiting showed no significant difference. Early trophic feeding was associated with improved clinical outcomes and better feeding tolerance.

Conclusion: Early initiation of trophic feeding within 24 hours appears beneficial in preterm low birth weight neonates, potentially improving health outcomes and reducing hospital resource use.