ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Neonatology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1544381
Impact of fast advancement and early fortification of enteral feedings in preterm infants, a retrospective, observational study
Provisionally accepted
- 1University of Kentucky, Lexington, United States
- 2St Bernards Regional Medical Center, Jonesboro, Arkansas, United States
- 3Astarte Medical, Yardley, United States
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We aimed to evaluate the outcomes and growth of preterm infants at a Neonatal Intensive Care Unit that focuses on early initiation, fast advancement, and early fortification of enteral feeds. Methods: Retrospective study conducted at a community hospital level III NICU. Extensive feeding data and outcomes were collected by utilizing a NutritionIQ software application, NICUtrition®. Infants born between 26- and 34-weeks gestational age were included, whereas infants with congenital defects, deceased or with incomplete data were excluded. Frequency and descriptive statistical analysis were conducted using chi-square and Fisher’s exact test. Unadjusted odds ratios were computed for categorical variables and general linear models were conducted to adjust for covariates (birth weight and gestational age) in sensitivity analyses. Results: A total of 297 preterm infants were included. On average, infants reached target enteral feeds of at least 120cc/kg/day and received fortification by day 6 of life. Achievement of target enteral feeds within the first week of life was associated with improved delta z-scores for weight and length as well as significantly less rates of sepsis. Infants that achieved target enteral feedings and fortification during the first week of life were associated with significantly improved delta z-scores for weight, length, and head circumference. Contrary to expectations, the use of Mother’s Own Milk alone was not associated with improved outcomes. Conclusions: This study highlights the association of early initiation, faster advancement and fortification of enteral feedings on preterm infants. These interventions improved growth metrics (weight, head circumference, and length z-scores) and were associated with decreased prevalence of sepsis.
Keywords: neonatal nutrition, Nutrition/Growth, Preterm feeding, feeding fortification, Newborn
Received: 12 Dec 2024; Accepted: 03 Sep 2025.
Copyright: © 2025 Gomez-Pomar, Clarke and Adams. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Enrique Gomez-Pomar, University of Kentucky, Lexington, United States
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