15Nov 2019


  • Division of Neonatology, Amrita Institute of Medical Sciences,Amrita Viswavidyapeetam,Kochi, 682041
Crossref Cited-by Linking logo
  • Abstract
  • References
  • Cite This Article as
  • Corresponding Author

Preterm very low birth infants are not fed early if there is shock or severe sepsis or respiratory distress. Traditionally if infants are sick enteral feedings are introduced slowly (at 4-5 days of age). Infants born with history of AREDF are given parenteral nutrition till enteral intake is adequate (7-10 days). We studied the effect of early MEN (at 24 hours of age) in VLBW (<32 weeks gestation) infants with AREDF (MEN group- n=12;controls-n=14). The results of this study reveals that the outcome of infants fed with early MEN is better with shorter length of stay, faster regaining of birth weight, shorter duration of parenteral nutrition and better tolerance of feedings. These data suggest that early MEN can be safely implemented in preterm VLBW infants with history of AREDF with no adverse outcomes

  1. Dorling J, Kempley S, Leaf A. Feeding growth restricted preterm infants with abnormal antenatal Doppler results. Arch Dis Child Fetal Neonatal Ed 2005;90:F359?63.
  2. Kamoji VM, Dorling JS, Manktelow B, Draper ES, Fieldet DJ. Antenatal umbilical Doppler abnormalities: an independent risk factor for early onset neonatal necrotizing enterocolitis in premature infants. Acta Paediatr2008;97:327?31.
  3. Vishal Vishnu Tewari, Sachin Kumar Dubey, Reema Kumar, Shakti Vardhan, C. M. Sreedhar, and Girish Gupta. Early versus Late Enteral Feeding in Preterm Intrauterine Growth Restricted Neonates with Antenatal Doppler Abnormalities: An Open-Label Randomized Trial. Journal of Tropical Pediatrics, 2018, 64, 4?14
  4. Maulik D, Mundy D, Heitmann E, Maulik D. Umbilical artery Doppler in the assessment of fetal growth restriction. Clin Perinatol 2011; 38:65?82
  5. Rochelson B, Schulman H, Farmakides G, Bracero L, Ducey J, Fleischer A, Penny B, Winter D. The significance of absent end-diastolic velocity in umbilical artery velocity waveforms. Am J ObstetGynecol 1987; 156: 1213?1218.
  6. Carol Lynn Berseth. Minimal Enteral Feedings. Clinics in Perinatology:1995,Volume 22: 1; 195?205
  7. Stevenson, D.K., Wright, L.L., Lemons, J.A. Oh W, Korones SB, Papile LA, Bauer C, Stoll BJ, Tyson JE, Shankaran S, Fanaroff AA, Donovan EF, Ehrenkranz RA, Verter J. Very low birth weight outcomes of the National Institute of Child Health and Human Development Neonatal Research Network, January 1993 through December 1994. Am J Obstet Gynecol. 1998; 179: 1632?1639
  8. Fanaroff, A.A., Stoll, B.J., Wright, L.L.,Carlo WA, Ehrenkranz RA, Stark AR, Bauer CR, Donovan EF, Korones SB, Laptook AR, Lemons JA, Oh W, Papile LA, Shankaran S, Stevenson DK, Tyson JE, Poole WK. NICHD Neonatal Research Trends in neonatal morbidity and mortality for very low birthweight infants. Am J Obstet Gynecol. 2007; 196: 147.e1?147.e8
  9. Manuck, T.A., Rice, M.M., Bailit, J.L. et al. Preterm neonatal morbidity and mortality by gestational age: a contemporary cohort. (103:e1-14) Am J Obstet Gynecol. 2016; 215
  10. Clark RH, Thomas P, Peabody J. Extrauterine Growth Restriction Remains a Serious Problem in Prematurely Born Neonates Pediatrics, 2003, 111 (5) 986-990.
  11. Garite TJ, Clark RH, Thorp JA. Intrauterine growth restriction increases morbidity and mortality among premature neonates. American Journal of Obstetrics and Gynecology, 2004,Volume 191, Issue 2, 481-487.
  12. Noori S and Istvan Seri. Etiology, Pathophysiology, and Phases of Neonatal Shock. (Chapter 1) in Hemodynamics and Cardiology: Neonatology Questions and Controversies. Book ? 2008, Pages 3-18. Editor Kleinman C. Elsevier. ISBN 978-1-4160-3162-8
  13. Acharya G, Sonesson SE, Flo K, Rasanan J, Odibo a. Hemodynamic aspects of normal human feto-placental (umbilical) circulation. Acta ObstetGynecolScand 2016; 95: 672?682.
  14. Karsdorp VH, van Vugt JM, van Geijn HP, Kostense PH, Arduim D, Montenegro N, Todros T. Clinical significance of absent or reversed end diastolic velocity waveforms in umbilical artery. Lancet 1994; 344: 1664?1668.
  15. Kiserud T, Ebbing C, Kessler J, Rasmussen S. Fetal cardiac output, distribution to the placenta and impact of placental compromise. Ultrasound ObstetGynecol 2006; 28: 126?136.

[Jayasree Chandramati, Prasanth Karakad and Sasidharan Ponthenkandath (2019); EFFECTS OF EARLY MINIMAL ENTERAL NUTRITION IN PRETERM VERY LOW BIRTHWEIGHT INFANTS WITH ABSENT OR REVERSAL OF END DIASTOLIC FLOW IN UMBILICAL ARTERIES (AREDF) BEFORE BIRTH Int. J. of Adv. Res. 7 (Nov). 141-144] (ISSN 2320-5407). www.journalijar.com

Sasidharan Ponthenkandath MD
Amrita Institute of Medical Sciences, Kochi


Article DOI: 10.21474/IJAR01/9985       DOI URL: http://dx.doi.org/10.21474/IJAR01/9985

Share this article