Comparison of Early Vs Late Initiation of Trophic Feeding in Preterm Neonates

Objective: To compare early versus late initiation of trophic feeding with respect to neonatal outcomes. Methods: A randomized controlled trial was conducted in the Neonatal Intensive Care Unit of Allied Hospital, Faisalabad, over six months. Sixty preterm neonates (1000–1500 g) were randomized into early trophic feeding (within 48 h of birth, n=30) and late trophic feeding (after 72 h of birth, n=30) groups. Primary outcomes assessed were the time required to regain birth weight, the duration of parenteral nutrition, and the overall length of hospitalization. Results: Baseline characteristics were comparable between groups. Infants in the early feeding group regained birth weight significantly sooner (13.6 ± 3.1 vs. 19.8 ± 4.9 days, p<0.001), required shorter parenteral nutrition (9.2 ± 1.7 vs. 14.6 ± 2.4 days, p<0.001), and had reduced hospital stay (12.6 ± 2.8 vs. 21.6 ± 4.2 days, p<0.001). No increase in necrotizing enterocolitis or sepsis was observed. Conclusion: Early trophic feeding is safe and effective in preterm neonates, improving weight regain and reducing hospital stay without added risk of complications. Implementation of early feeding protocols should be considered to optimize neonatal outcomes.