Time to full enteral feeds in hospitalised preterm and very low birth weight infants in Nigeria and Kenya

• DOI: 10.1371/journal.pone.0277847
• Publication Date: 2024-03-08T18:34:06Z
• Authors: Zainab O. Imam; Helen M. Nabwera; Olukemi O. Tongo; Pauline E. A. And...; Isa Abdulkadir; Chinyere V. Ezeaka; Beatrice N. Ezenwa; Iretiola B. Fajolu; Martha K. Mwangome; Dominic D. Umoru; Abimbola E. Akind...; Walter Otieno; Macrine Olwala; Grace M. Nalwa; Alison W. Talbert; Ismaela Abubakar; Nicholas D. Embleton; Stephen J. Allen
• Keywords: Enteral administration; Quartile

Background Preterm (born < 37 weeks’ gestation) and very low birthweight (VLBW; <1.5kg) infants are at the greatest risk of morbidity mortality within first 28 days life. Establishing full enteral feeds is a vital aspect their clinical care. Evidence predominantly from high income countries shows that early rapid advancement safe reduces length hospital stay adverse health outcomes. However, there limited data on feeding practices factors influence attainment among these vulnerable in sub-Saharan Africa. Aim To identify time to feeds, defined as tolerance 120ml/kg/day, hospitalised preterm VLBW neonatal units two African countries. Methods Demographic variables were collected for newborns admitted 7 Nigeria Kenya over 6-months. Multiple linear regression analysis was conducted independently associated with feeds. Results Of 2280 newborn admitted, 484 VLBW. Overall, 222/484 (45.8%) died half deaths (136/222; 61.7%) occurring before feed. The median (inter-quartile range) feed 46 (27, 72) hours life (tFEF) 8 (4.5,12) marked variation between units. Independent predictors tFEF (unstandardised coefficient B 1.69; 95% CI 1.11 2.26; p value <0.001), gestational age (1.77; 0.72 2.81; occurrence respiratory distress (-1.89; -3.50 -0.79; <0.002) necrotising enterocolitis (4.31; 1.00 7.62; <0.011). Conclusion use standardised guidelines may decrease variations practice, shorten thereby improve