Document Detail

Hydrolyzed protein accelerates feeding advancement in very low birth weight infants.
MedLine Citation:
PMID:  12456919     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Feeding intolerance is common in very low birth weight (VLBW; <1500 g) infants. Hydrolyzed protein preterm infant formula (HPF) has been shown to accelerate the gastrointestinal transit of formula. The aim of this study was to investigate whether HPF improves early feeding tolerance compared with standard preterm infant formula (SPF). We hypothesized that HPF would accelerate early enteral feeding advancement. METHODS: Primary outcome was the time from initiation of milk feeds until full feeds (150 mL/kg birth weight/d) were achieved in infants who received <10% human milk (HM) to exclude HM as a confounder. Because the availability of HM was not predictable at the time of enrollment, all eligible VLBW infants (n = 129) were randomly assigned in a randomized, controlled trial to receive HPF or SPF if HM was not available. Infants who received >10% HM (n = 42) were excluded. Milk bolus feeding every 2 to 3 hours was started at the discretion of the attending physician and advanced by 16 mL/kg/d. Preprandial gastric residuals were tolerated up to 5 mL/kg; otherwise, feedings were reduced or withheld. Data are shown as median (5th and 95th percentile). RESULTS: Forty-six and 41 (HPF vs SPF) infants received <10% HM. There was no significant difference with regard to birth weight, gestational age, and onset of milk feeds (day 3 [1-8] vs 4 [2-6]). The time from initiation of milk feeds to full feeds was significantly shorter with HPF feeding (10 [9-27] vs 12 [9-28] days). CONCLUSION: HPF improved the feeding tolerance and enabled a more rapid establishment of full enteral feeding in VLBW infants compared with SPF.
Walter A Mihatsch; Axel R Franz; Josef Högel; Frank Pohlandt
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatrics     Volume:  110     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-11-28     Completed Date:  2002-12-11     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1199-203     Citation Subset:  AIM; IM    
Division of Neonatology and Pediatric Critical Care, Department of Pediatrics, Ulm University, 89070 Ulm, Germany.
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MeSH Terms
Double-Blind Method
Enteral Nutrition
Feeding and Eating Disorders of Childhood / prevention & control
Infant Food
Infant Nutritional Physiological Phenomena
Infant, Newborn
Infant, Very Low Birth Weight / physiology*
Milk, Human
Protein Hydrolysates / administration & dosage*
Reg. No./Substance:
0/Protein Hydrolysates

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