Table 1

Characteristics of included reviews

ReviewPopulationIntervention armComparison armOutcomes reported
1.How to advance feeds
Abiramalatha et al24Preterm (<37 weeks) or low birthweight (<2500 g) infantsHigh volume enteral feeds up to 300 mL/kg/dayStandard volume enteral feeds ≤200 mL/kg/day
  • Weight gain during hospital stay

  • Feed intolerance

  • Necrotising enterocolitis

Oddie et al22Enterally fed very preterm (<32 weeks) or VLBW infantsFaster advancement of enteral feedsAdvancement of enteral feeds no faster than 24 mL/kg (birth weight or current weight) per day
  • Feed intolerance

  • Time to establish full enteral feeding

  • Incidence of invasive infections

  • Necrotising enterocolitis

  • Duration of hospital stay

  • Mortality

Alshaikh et al23VLBW (1000 to <1500 g) stable newborn infantsEnteral feeds started on day 1 at 80 mL/kg/day and increased by 20 mL/kg/dayEnteral feeds started on day 1 at ≤30 mL/kg/day and increased by 20 mL/kg/day
  • Time to regain birth weight

  • Feed intolerance: time to establish full enteral feeds.

  • Necrotising enterocolitis and sepsis

  • Duration of hospital stay

2.What to feed
Brown et al20Preterm (<37 weeks) and low birthweight (<2500 g) infants receiving breast milk in hospitalFortification of breast milk with energy (carbohydrate or fat) and protein. Fortifiers could additionally include micronutrients and vitaminsBreast milk not fortified with energy or protein but can receive micronutrients and vitamins
  • Growth: weight, length, head circumference

  • Length of hospital stay

  • Feed intolerance

  • Necrotising enterocolitis

  • Bone mineralisation: serum alkaline phosphatase, bone mineral content

  • Neurodevelopmental outcomes at 18 months: mental development index and psychomotor development index

Amissah et al25Preterm (<37 weeks) infants receiving enteral feeding of human milk in hospitalHuman milk with additional fat supplementationHuman milk without additional fat supplementation
  • Growth: weight, length, head circumference

Amissah et al26Preterm (<37 weeks) infants receiving human milk in hospitalHuman milk with additional carbohydrate supplementationHuman milk without additional carbohydrate supplementation
  • Weight at day 30 of age

  • Duration of hospital stay

  • Feed intolerance

  • Necrotising enterocolitis

3.How to feed
Watson et al27Preterm (<37 weeks) or low birthweight (<2500 g) infants receiving tube feedingNasal placement of feeding tubesOral placement of feeding tubes
  • Time to establish full tube feeds

  • Time to regain birth weight

  • Weight gain

  • Time to independence from supplemental oxygen

Premji and Chessell21VLBW infants with no history of feeding or feed intolerance and no congenital anomalies that might interfere with establishing enteral feedsContinuous nasogastric feeding with human milk or infant formulaIntermittent bolus nasogastric feeding with human milk or infant formula
  • Time to establish full enteral feeds

  • Time to establish full oral feeds

  • Feed intolerance

  • Days on TPN

  • Time to regain birth weight

  • Growth: weight, length, head circumference, triceps skinfold thickness

  • Duration of hospital stay

  • Days to discharge weight of 2040 g

  • Days on mechanical ventilation

  • Proven or probable necrotising enterocolitis

  • Failure to complete protocol due to feed intolerance

  • Apnoea

  • TPN, total parenteral nutrition; VLBW, very low birth weight (<1500 g).