Premature baby care: when is it best to start milk feeds?

This research was completed on 31 December 2009

Project Leader	Prof P Brocklehurst MRCOG MSc, Dr A Leaf MD, Dr J S Dorling MRCPCH, Dr S T Kempley MA FRCP FRCPCH, Dr P A Mannix MBBS MD MRCP FRCPCH and Dr K P B McCormick
Location	National Perinatal Epidemiology Unit, University of Oxford, in conjunction with the Neonatal Intensive Care Unit, Southmead Hospital, Bristol, the Division of Child Health, University of Leicester, the Neonatal Unit, Northwick Park and St Mark's Hospital, Harrow the Neonatal Unit, Women's Centre, John Radcliffe Hospital, Oxford and the Royal London Hospital.
Grant awarded	29 October 2004
Start date	6 June 2005
End date	31 December 2009
Grant amount	£203,593.00
Grant code	SP4006

Small, premature babies urgently need good nutrition to grow, but are at risk of complications. Their digestive system is not fully developed and feeding with milk is one of the recognised risk factors for inflammation of the bowel wall. This is called necrotising enterocolitis and has a mortality rate of approximately one in five. Although milk feeds are often withheld for the first few days of life, and intravenous nutrition given, this increases the risk of dangerous blood stream infections (sepsis). The needs and risks are greater for small babies that have grown poorly in the womb (intrauterine growth restriction), especially those that have abnormalities of the blood flow in the umbilical artery before birth. It is estimated that this may affect up to 2,000 babies per year in the UK. It is not currently known whether starting milk feeds early (24–48 hours after birth) or late (120–144 hours after birth) is better for these babies. This study will compare early with late initiation of milk feeding. The team will compare the time to establish milk feeding, the incidence of necrotising enterocolitis, episodes of infection, the duration of intensive care and the growth rate between these babies in order to determine which policy is the most beneficial.