ArticleJAMA network open2025
Time to Full Enteral Feeds and Late-Onset Sepsis in Extremely Preterm Infants.
Article in JAMA network open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Observational
- Determinants of time to full enteral nutrition and its association with short-term outcomes in very and extremely low birth weight infants: a multicenter study in China.BMC pediatrics · 2026Observational
- In the modern era of human milk-based feeding, is the greater risk to extremely preterm infants feeding too early or feeding too little?Pediatric research · 2026Article
- Early enteral nutrition practices and their association with growth and necrotising enterocolitis in extremely preterm infants-A dual national cohort study.Pediatric research · 2026Article
- Enteral feeding practices and guideline adherence for very low birth weight infants in Chinese NICUs: a multicentre cross-sectional survey.Frontiers in nutrition · 2026Article
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Authors and funding
11 authors.
Funding
Abstract
Importance: Recent studies suggest that early achievement of full enteral feeding improves clinical outcomes among preterm infants. Objective: To examine the association between full enteral feeding and late-onset sepsis. Design, Setting, and Participants: This secondary analysis of a cohort study prospectively followed up a multicenter cohort of preterm infants with gestational ages ranging from 23 to 28 weeks born between January 1, 2012, and December 31, 2021, at 19 US academic centers. Infants without major anomalies who received enteral feedings and survived beyond postnatal day 7 were included. Exposure: Full enteral feeding (≥120 mL/kg/d). Main Outcomes and Measures: The primary outcome was the incidence of late-onset sepsis confirmed through culture-positive results occurring more than 72 hours after birth and treated with antibiotics for 5 or more days. Other clinical outcomes assessed up to 36 weeks of postmenstrual age included necrotizing enterocolitis, death, and growth faltering (weight, length, or head circumference z score decrease >1.2). Risk estimates were adjusted for clinical variables associated with acute critical illness and birth year. Results: Demographic and clinical data from 15 102 preterm infants were analyzed (mean [SD] maternal age, 28.7 [6.1] years; mean [SD] gestational age, 26.0 [1.6] weeks; mean [SD] birth weight, 875 [242] g; 7648 male [50.6%]). Between January 1, 2012, and December 31, 2021, the median (IQR) time to achieve full enteral feeding decreased from 18 (14-28) days to 14 (10-22) days, and the incidence of late-onset sepsis decreased from 21.1% to 16.5% (P = .003). In adjusted analyses, the relative risk of late-onset sepsis per each additional 1-week delay in achieving full enteral feeding was 16% higher (adjusted relative risk [ARR], 1.16; 95% CI, 1.14-1.18; P < .001). Delays in achieving full enteral feeding were also associated with a higher risk of necrotizing enterocolitis (ARR, 1.20; 95% CI, 1.16-1.24; P < .001) and growth faltering in weight (ARR, 1.08; 95% CI, 1.07-1.09), length (ARR, 1.03; 95% CI, 1.02-1.03), and head circumference (ARR, 1.07; 95% CI, 1.06-1.08; P < .001 for all). Conclusions and Relevance: In this cohort study of preterm infants with gestational ages ranging from 23 to 28 weeks who received enteral feeds and survived beyond postnatal day 7, delays in establishing full enteral feeding were associated with a higher risk of late-onset sepsis. These results suggest that early initiation and advancement of enteral feeding have the potential to reduce the risk of late-onset sepsis, growth faltering, and necrotizing enterocolitis.
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