Small Starts, Big Challenges: Feeding Progression in Extremely Low Birth Weight Infants in a Resource-Limited NICU
1
Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A2265
ABSTRACT
BACKGROUND:
Suboptimal nutritional management contributes to extrauterine growth restriction (EUGR), which is associated with adverse short- and long-term outcomes. Rapid advancement through feeding milestones supports growth, improves clinical outcomes, and shortens hospital stays. However, data on feeding strategies for extremely low-birth-weight (ELBW) infants in resource-limited settings such as South Africa remain scarce.
METHODS:
This retrospective descriptive–analytical study reviewed the medical records of 128 premature infants weighing ≤1500 g. Infants were categorised into extremely low birth weight (<1000 g) and very low birth weight (1001–1500 g) cohorts to compare feeding progression. Data extracted from the hospital’s Enterprise Content Management system included demographics, anthropometrics, nutritional information, and clinical outcomes. Descriptive statistics summarised feeding progression, while analytical tests (including t-tests) assessed factors associated with feeding advancement and differences between cohorts.
RESULTS:
Enteral feeds began at a mean of 1.75 days (±1.05), and full oral feeds were reached at a mean of 33 days (±15.11). Significant differences between cohorts were observed in total fluid and milk volumes at milestones two (p = 0.037) and three (p = 0.027), as well as time to milestones three, four, and five (all p < 0.001). Weekly weight loss occurred across all birth weight categories. Common comorbidities included respiratory distress syndrome (72.6%), patent ductus arteriosus (15.6%), neonatal jaundice (84.4%), necrotizing enterocolitis (3.13%), and feeding intolerance (25.78%). Most infants (85%) received antibiotics, and sepsis accounted for 17 deaths (13.3%).
CONCLUSIONS:
Birth weight remains a strong predictor of feeding progression, underscoring the need for tailored nutritional strategies in premature infants
Suboptimal nutritional management contributes to extrauterine growth restriction (EUGR), which is associated with adverse short- and long-term outcomes. Rapid advancement through feeding milestones supports growth, improves clinical outcomes, and shortens hospital stays. However, data on feeding strategies for extremely low-birth-weight (ELBW) infants in resource-limited settings such as South Africa remain scarce.
METHODS:
This retrospective descriptive–analytical study reviewed the medical records of 128 premature infants weighing ≤1500 g. Infants were categorised into extremely low birth weight (<1000 g) and very low birth weight (1001–1500 g) cohorts to compare feeding progression. Data extracted from the hospital’s Enterprise Content Management system included demographics, anthropometrics, nutritional information, and clinical outcomes. Descriptive statistics summarised feeding progression, while analytical tests (including t-tests) assessed factors associated with feeding advancement and differences between cohorts.
RESULTS:
Enteral feeds began at a mean of 1.75 days (±1.05), and full oral feeds were reached at a mean of 33 days (±15.11). Significant differences between cohorts were observed in total fluid and milk volumes at milestones two (p = 0.037) and three (p = 0.027), as well as time to milestones three, four, and five (all p < 0.001). Weekly weight loss occurred across all birth weight categories. Common comorbidities included respiratory distress syndrome (72.6%), patent ductus arteriosus (15.6%), neonatal jaundice (84.4%), necrotizing enterocolitis (3.13%), and feeding intolerance (25.78%). Most infants (85%) received antibiotics, and sepsis accounted for 17 deaths (13.3%).
CONCLUSIONS:
Birth weight remains a strong predictor of feeding progression, underscoring the need for tailored nutritional strategies in premature infants
| eISSN: | 2654-1459 |
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