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.
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.
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#: 
May, 2010
Authored by: 
Brian R McAvoy