Comparing Abdominal Circumference to Gastric Residual Volume for Assessing Feed Intolerance in Low Birth Weight Infants: A Prospective Cohort Study

Introduction: Babies with feed intolerance usually present with vomiting, abdominal distension and the presence of gastric residues. Feed intolerance can be clinically diagnosed through the assessment of prefeed Gastric Residual Volume (GRV), the colour of gastric aspirates, abdominal distension, emesis, bloody stools and increased apnoea and/or bradycardia. Aim: To evaluate prefeed Abdominal Circumference (AC) and GRV for feed intolerance in low birth weight infants and also to assess the time taken to achieve 150 mL/kg full feeds. Materials and Methods: This prospective cohort study was conducted in the Department of Paediatrics at the Kempegowda Institute of Medical Sciences, Bengaluru, Karnataka, India, from January 2021 to June 2022. A total of 100 neonates weighing less than 2.5 kg were included in the study. Group 1 was subjected to measurement of prefeed AC, while group 2 was subjected to measurement of prefeed gastric aspirate as a measure of feed intolerance. Inferential statistics such as the Chi-square test, t-test and other appropriate tests were used whenever applicable. A p-value of less than 0.05 was considered statistically significant. Results: Between the two groups considered in the study, the mean age of infants in group 1 and group 2 were 34.48 days and 33.04 days, respectively, with a mean birth weight of 1.82 kg and 1.72 kg in group 1 and group 2, respectively. In the present study, nine infants were in group 1 and 14 infants were in group 2, both showing signs of feed intolerance. The mean time required to reach full feeds in infants of group 1 was 8.72 days, while in group 2, it was 10.88 days. Conclusion: Both AC and GRV are useful indicators of feed intolerance; however, AC shows better results in terms of achieving full feeds, feed tolerance and the period of recovery. Nonetheless, the results obtained in the AC group are not statistically significant compared to the results obtained from the prefeed gastric aspirate group.