The relationship between velocity growth and nutritional support practices was assessed with data prospectively collected on 1665 infants [birthweight(BW) 50 -1500 gm] admitted to the 12 Network centers between 8/31/94 and 8/9/95. Infants had been admitted at age ≤ 24 hrs, survived > 7 d, and were free of major congenital anomalies. They were followed until discharge, transfer, age 120 d or until reaching a body weight (WT) of 2000 gm. WT was recorded daily until BW was regained and/or a minimum of 14 d, then it was recorded weekly. Mean days to regain and maintain BW for 2 d, days of parenteral nutritional (PN) providing ≥ 75% daily fluid volume, age at first and to full enteral feeding, and average daily WT gain (between the day BW regained and 2000g is reached) are shown (Table) for 100 gm BW groups. Analyses were done for each group separately using a random effects regression model for longitudinal data. For each BW group, the duration of PN ≥ 75% intake and age at first full enteral feeding had a small effect on the rate of WT gain; but a delay of 1 wk in the age at first enteral feeding was associated with a decrease in the rate of WT gain by 2-4 g/d. These data agree with the suggestion that early initiation of enteral feeding facilitates WT gain and show the average daily weight gain achievable by VLBW infants with current nutritional practices.

Table 1
Full size table