A feeding protocol for healthy preterm infants that shortens time to oral feeding

Objective: To test the hypothesis that healthy preterm infants randomly assigned to a semi-demand feeding protocol would require fewer days to attain oral feeding and have a satisfactory weight gain compared with control infants receiving standard care. Study design: In 2 neonatal intensive care nurseries, 81 infants 32 to ≤ 34 weeks' postconceptional age were randomly assigned to the control (n = 41) or experimental (n = 40) protocol for transition from gavage to oral feedings. The control protocol followed the standard practice of gradually increasing scheduled oral feedings, whereas the experimental protocol used a semi-demand feeding method contingent on infant behavior. Analysis of variance techniques were used to compare the study groups for number of days to attain oral feeding and weight gain. Results: The semi-demand method shortened the time for infants to achieve oral feeding by 5 days (P < .001). There were no differences in weight gain between the study groups, and both groups had satisfactory weight gain. Conclusion: The semi-demand method for the transition from gavage to oral feeding in healthy, preterm infants 32 to ≤ 34 weeks postconceptional age promotes faster attainment of oral feeding and does not compromise their weight gain. (J Pediatr 2001;139: 374-9)