Achievement of full enteral feeding using volume advancement in infants with birth weight 1,000 to <2,000 grams

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Teti Hendrayanti
Afifa Ramadanti
Indrayady Indrayady
Raden Muhammad Indra


Background Early enteral feeding is one of the efforts to improve gastrointestinal adaptability in preterm infants. Volume advancement (VA) enteral feeding has been associated with less time to reach full feeding, which can improve outcomes.

Objective To evaluate the duration of VA needed to achieve full enteral feeding (FEF) in low birth weight (LBW) and very low birth weight (VLBW) infants and related factors.

Methods This prospective study was done in infants with birth weight 1,000 to <2,000 grams in the Neonatal Ward and NICU of Dr. Moh. Hoesin General Hospital, Palembang, South Sumatera. All infants underwent VA feeding. The time needed to achieve FEF (150 ml/kg/day) was recorded. Several clinical factors were analyzed for possible associations with the success rate of achieving FEF within 10 days of feeding.

Results Thirty-five infants were included in this study with a mean gestational age of 31.83 (SD 2.67) weeks.  Their median body weight at the start of protocol was 1,400 (range 1,000 – 1,950) grams and 80% had hyaline membrane disease. Median time to achieve FEF was 11 (range 8–21) days, with 48.6% subjects achieving FEF in ≤10 days. Gestational age <32 weeks (OR 5.404, 95%CI 0.963 to 30.341), birth weight <1,500 grams (OR 5.248, 95%CI 0.983 to 28.003), and male (OR 4.751, 95%CI 0.854 to 26.437) gender were associated with the failure of achieving FEF within 10 days of feeding, however, no factors remained statistically significant after multivariate analysis.

Conclusion Full enteral feedings in infants with birth weight 1,000 to <2,000 grams with VA feeding are achieved within a median of 11 days. Gestational age, birth weight, and gender are not associated with time needed to achieve FEF.

Article Details

How to Cite
Hendrayanti T, Ramadanti A, Indrayady I, Indra RM. Achievement of full enteral feeding using volume advancement in infants with birth weight 1,000 to &lt;2,000 grams. PI [Internet]. 7Jul.2020 [cited 15Jun.2021];60(4):173-. Available from:
Received 2019-10-18
Accepted 2020-07-07
Published 2020-07-07


Usman A. Klasifikasi bayi menurut berat lahir dan masa gestasi. In: Kosim S, Yunanto A, Dewi R, Sarosa GI, Usman A, editors. Buku ajar neonatologi. 1st ed. Jakarta: Badan Penerbit IDAI; 2014. p. 12-5.
2. Gomella TL, Cunningham MD, Eyal FG, Tuttle DJ. Neonatology management, procedures, on-call problems, diseases, and drugs. 7th ed. New York: McGraw Hill Education; 2013. p.29-31.
3. Gebregzabiherher Y, Haftu A, Weldemariam S, Gebrehiwet H. The prevalence and risk factors for low birth weight among term newborns in Adwa General Hospital, Northern Ethiopia. Obstet Gynecol Int. 2017;2017:2149156. DOI: 10.1155/2017/2149156.
4. Andayasari L, Opitasari C. Parity and risk of low birth weight infant in full term pregnancy. Health Sci J Indones. 2016;7:13–6.
5. Linsell L, Malouf R, Morris J, Kurinczuk JJ, Marlow N. Prognostic factors for poor cognitive development in children born very preterm or with very low birth weight: a systematic review. JAMA Pediatr. 2015;169:1162-72. DOI: 10.1001/2015/2175.
6. Ballot DE, Ramdin T, Rakotsoane D, Agaba F, Chirwa T, Davies VA, et al. Assessment of developmental outcome in very low birth weight infants in Southern Africa using the Bayley Scales of Infant Development (III). BMJ Paediatr Open. 2017;1:e000091. DOI: 10.1136/2017/000091.
7. Dutta S, Singh B, Chessell L, Wilson J, Janes M, McDonald K, et al. Guidelines for feeding very low birth weight infants. Nutrients. 2015;7:423-42. DOI: 1 0.3390/nu7010423.
8. World Health Organization.. WHO child growth standards: length/height-for-age, weight-forage, weight-for-length, weight-for-height and body mass index-for-age; methods and development. Geneva: WHO Press; 2006.
9. Zubani A, Mersal A, Al Saedi S, Al Ahmadi K, Al Deek A, Sadiq B. Comparison of volume and frequency based feeding protocols in very low birth weight infants: a prospective randomized study. J Clin Neonatol. 2016;5:233-7. DOI: 10.4103/2249-4847.194167.
10. Williams A. Early enteral feeding of the preterm infant. Arch Dis Child Fetal Neonatal Ed. 2000;83:F219 - 20.
11. Corvaglia L, Fantini MP, Aceti A, Gibertoni D, Rucci P, Baronciani D, et al. Predictors of full enteral feeding achievement in very low birth weight infants. PLoS ONE. 2014;9:e92235. DOI: 10.1371/2014/0092235.
12. Gianino NM, Vieira AA, Moreira MEL. Evaluation of the nutritional status at 40 weeks corrected gestational age in a cohort of very low birth weight infants. J Pediatr (Rio J). 2005;81:34-40. PMID: 15742084.
13. Lubis G, Suciati RT. Hubungan pemberian enteral makanan dini dan pertambahan berat badan pada bayi prematur. Sari Pediatr. 2007;9:145-50. DOI: 10.14238/sp9.2.2007.145-50.