Limited evidence for benefits of ad libitum feeding for preterm infants

Clinical question: 
How effective is ad libitum or demand/semi-demand feeding for preterm infants in the transition phase from intragastric tube to oral feeding?
Bottom line: 
Three trials reported that, compared with scheduled interval feeding, an ad libitum or demand/semi-demand feeding regimen for preterm infants allowed earlier attainment of full oral feeding and earlier hospital discharge (by about 2 to 4 days). Other trials did not confirm this finding.
Caveat: 
The trials were generally small and of variable methodological quality. The duration of the intervention and the duration of data collection and follow-up in most of the trials were not likely to have allowed detection of measurable effects on growth.
Context: 
Scheduled interval feeding of prescribed enteral volumes is current standard practice for preterm infants. Feeding preterm infants in response to their hunger and satiation cues (ad libitum or demand/ semi demand) rather than at scheduled intervals might help in the establishment of independent oral feeding, increase nutrient intake and growth rates, and allow earlier hospital discharge.
Review CD#: 
CD005255
PEARLS No: 
259
Date: 
May, 2010
Authored by: 
Brian R McAvoy