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RESEARCH PRODUCT

Enteral feeding policies for extremely low birth weight infants. A survey in 74 Italian neonatal intensive cAre units

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Background: Enterai feeding for infants with birth weight1000 g (ELBWI) is still a controversial issue. The aim of the present survey was to ascertain the attitudes of Italian neonatal intensive care units (NICUs) regarding this point. Method: A questionnaire, with multiple choice answers, regarding the timing of enteral feeding, its progression, the different techniques utilised, the eventual use of fortifiers and the interrupting criteria, was mailed to 92 Italian NICUs. Results: 74 NICUs all over the country participated in the study.1153 ELBWI were hospitalised in 1996 in these Units. Enterai feeding for babies between 501 g and 750 g is started on the 1st day of life in 23.3% of the NICUs and for babies between 751 g and 1000 g in 36.5%. NICUs that start enteral feeding not later than the 3rd day of life are 75.3% and 86.5% respectively. The most frequent investigation prior to starting enterai feeding was the evaluation of gastric aspirate. Mechanical ventilation is considered a contraindication for starting enterai feeding only in 1/4 of NICUs. Enterai feeding is started most often with glucose water solution and raw human milk. The most frequent administration techniques are interminent oro- and nasogastric gavage. Pasteurization facilities are available in 31 % of NICUs, but are located mostly in the Centre and North of Italy. Conclusion: This survey shows that enterai feeding policy for ELBWI varies among different Italian NICUs. In Italy there is a common tendency to start feeding early, even in ventilated infants.