Feeding, medical factors, and developmental outcome in premature infants

This is a prospective, longitudinal study of premature infants investigating whether the length of time needed to reach full enteral feedings (F(EF)) or full nipple feedings (F(NF)) is related to medical complications and/or developmental outcome at 24 months corrected age. Premature infants (n=161) from three institutions with birth weights less than 1,600 grams were followed up from birth to 24 months corrected age. The infants were stratified into groups by the severity of medical complications. Bayley Scales of Infant Development were performed at 24 months corrected age. Multiple linear regression was used to analyze the association between feeding milestones, medical complications, and developmental outcomes. Our results show that when controlling for birth weight and gestational age (GA), the severity of respiratory complications was significantly related to reaching FEV (p=0.024) and F(NF) (p=0.0014). Furthermore, when controlling for the severity of respiratory complications, GA, and socioeconomic status, an increased length of time to F(EF) was significantly associated with a poorer mental outcome (p=0.0013). We conclude that there is an association between the length of time to reach F(EF) and mental developmental outcome at 24 months corrected age. Infants who reach full enteral feedings at an earlier age appear to have a better developmental outcome despite their GA and severity of respiratory complications.