Background / Aims: Moderate-late-preterm (MLPT) births (32+0 and 36 weeks’ gestation) account for >80% of preterm babies born in NZ. Survival is excellent, but MLPT babies are at increased risk for adverse long-term health outcomes, including obesity, hypertension and diabetes. By the time MLPT babies reach their due date, they have significantly greater fat mass than babies born at term3, suggesting that the time between early birth and due date is a critical period for the development of later obesity.
Current feeding strategies for MLPT babies whilst waiting for full sucking breast-feeds to be established are not based on any evidence. This factorial trial will investigate the impact of commonly-used feeding strategies and the role of smell and taste, currently ignored in tube-fed babies, on the development of fat mass and on attainment of full sucking feeds.
Aims: Investigate the impact of different feeding strategies on feed tolerance, body composition, and microbiome composition.
Methods: Multi-site, randomised, factorial design, clinical trial (see table).
Participants: MLPT babies whose mothers intend to breast-feed.
Interventions and comparators: (i) parenteral nutrition vs 10% dextrose intravenously; (ii) supplemental milk (donor breast milk/standard infant formula) vs only mother’s own milk; (iii) infants exposed to smell and taste of milk prior to every nasogastric tube feed vs no exposure.
Results: Primary outcome: For (i) and (ii) % fat mass at 4 months’ corrected age measured by air displacement plethysmography; for (iii) time to full enteral feeds. Secondary outcomes: Length of hospital stay; Breastfeeding rates; Days to full suck feeds; Growth; Gut Microbial composition.
Conclusions: This study will provide first evidence on the effects of different feeding strategies on the growth and neurodevelopment of moderate to late preterm babies and will therefore inform practice.
Counties Manukau Health