A web-based survey of 127 tertiary neonatal intensive care units in a variety of countries across the world was carried out to evaluate enteral feeding practices.
The countries included in the survey were: Australia, Canada, Denmark, Ireland, New Zealand, Norway, Sweden and the UK. A total of 124 units (98%) responded to the survey. Of these, 59 units (48%) had a breastmilk bank or access to donor human milk (Australia/New Zealand 2/27, Canada 6/29, Scandinavia 20/20 and UK/Ireland 31/48).
When asked about initiating enteral feeding within the first 24 hours of life the proportion of units doing this was: 35% if gestational age (GA) <25 weeks, 43% if GA 25–27 weeks and 71% if GA 28–31 weeks. In general, Scandinavian units introduced enteral feeds the earliest, followed by UK/Ireland.
Continuous feeding was routinely used for infants below 28 weeks' gestation in almost half of the Scandinavian units and in approximately one sixth of units in UK/Ireland, but rarely in Australia/New Zealand and Canada. Minimal enteral feeding for 4–5 days was common in Canada, but rare in Scandinavia. Target enteral feeding volume in a ‘stable’ preterm infant was 140–160ml/kg/day in most Canadian units and 161–180ml/kg/day or higher in units in the other regions. There were also marked regional differences in criteria for use and timing when human milk fortifier was added.
The authors concluded that there are significant areas of uncertainty and marked variability in feeding practices.
Klingenberg C, Embleton ND, Jacobs SE et al (2011) Enteral feeding practices in very preterm infants: an international survey. Arch. Dis. Child. Fetal Neonatal Ed. 10.1136/adc.2010.204123
