Effect of Rapid Enteral Feeding Advancement on Sepsis and NEC in Preterm Neonates

Background: Preterm neonates face high risks of sepsis and necrotizing enterocolitis (NEC), which contribute to neonatal morbidity and mortality. Optimal enteral feeding advancement remains debated, especially in resource-limited settings where cautious feeding is practiced to prevent complications. However, extended parenteral nutrition may increase sepsis risk. This study evaluates the effect of rapid versus gradual enteral feeding advancement on sepsis and NEC incidence in preterm neonates. Methods: A randomized controlled trial was conducted at the Department of Neonatology, Bangladesh Shishu Hospital & Institute, from July 2022 to June 2024. A total of 88 hemodynamically stable preterm neonates (gestational age 30–<37 weeks; birth weight 1000–<2500 g) were randomly allocated to either a rapid (Group A) or gradual (Group B) enteral feeding advancement protocol. Data on clinical outcomes, including sepsis and NEC, were collected using structured tools and analyzed with SPSS v26. Chi-square and Mann-Whitney U tests were used, with p < 0.05 considered statistically significant. Results: Sepsis occurred in 13.6% of Group A and 27.3% of Group B neonates (p = 0.113). NEC was observed in 4.5% and 6.8% of neonates in Groups A and B, respectively (p = 0.999). No significant differences were observed between groups. Conclusion: Rapid enteral feeding advancement appears to be a safe and feasible strategy for preterm neonates, with a trend toward reduced sepsis.