Text Box: RISK FACTORS OF FEEDING INTOLERNCE (FI) IN VLBW INFANTS
Kwinta P., Mitkowska Z., Tomasik T., Pietrzyk J.J.
Department of Pediatrics, Jagiellonian University, Cracow, Poland

Objective: To evaluate risk factors of feeding intolerance in VLBW infants.
Methods: Prospective study of 89 newborns with mean (¡ÀSEM) birth weight (BW) 1084¡À24g and gestational age (GA) 28,3¡À0,25 wks were performed. In all babies the same schedule of feeding introduction during the first month of life was used. The feeding was started if infant fulfilled the following criteria: 1) absence of significant abdominal distention, 2) no signs of peritonitis, 3) evidence of proper peristaltic activity, 4) passage of stools, 5) no signs of GI obstruction, 6) no evidence of gastrointestinal bleeding, 7) respiratory, cardiovascular and hematological stability.
Results: Feeding intolerance was noted in 30 cases. The risk of feeding intolerance was statistically higher in the group of infants weighing £ 1000g than in the group of infants weighing 1001-1500g (RR=1,93; 95%CI: 1,07-3,46; p=0,04) and in the group of infants with GA <29 wks compared with infants with GA³29 wks. (RR=3,9; 95%CI: 1,64-9,25). Another factor associated with higher risk of feeding intolerance was daily feeding increments (10 ml/kg vs 5 ml/kg: RR=1,89; 95%CI: 0,96-3,72; p=0,054). Feeding intolerance was also more frequently observed in children with central venous catheter (RR=3,14; 95%CI: 1,05-9,37; p=0,03). Factors such as Apgar score, sex, type of delivery, formula type and time of introduction of feeding were not connected with higher risk of feeding intolerance. Moreover, neither treating the child with a mechanical ventilation nor the presence of intracranial hemorrhage were risk factors of FI.
Conclusion: The most significant risk factor of feeding intolerance in VLBW infants is maturity of the newborn. Also the daily feeding increments higher than 10 ml/kg increase the risk of FI in VLBW infants.
1994