Optimal nutrition during the neonatal period is essential for growth and development throughout infancy and into childhood. Nutrients can be provided either parenterally or enterally but the aim in all infants to use full enteral feeding as soon as it is safe to do so. Because of poor co-ordination sucking and swallowing, very low birth weight infants (VLBW) are fed by gavage and are unable to regulate their own enteral intake. Therefore the rate at which feeding to be advanced must be determined by caregivers. Based largely on retrospective studies, there is concern that advancing feeding too rapidly may increase the risk of Necrotizing enterocolitis (NEC). It is thought that one possible way to prevent this condition is to limit the amount of milk feeds that infants receive each day for the first few weeks after birth. On the other hand there are potential disadvantages associated with slowing the advancement of enteral feed volumes, such as establishment of full enteral nutrition are delaying. So, controversy exists regarding role of advancement of eneral feeding. So the review has discussed the effect of slow versus rapid rates of advancement of enteral feeding volume in VLBW infants.

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Dr Firoz Ahmed

Resident Physician, Department of Paediatrics, Sher-e-Bangla Medical College Hospital, Barisal, Bangladesh

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