Effects of enteral feeding temperature on feeding intolerance among preterm infants

Introduction: Feeding intolerance is one of the most frequent problems among preterm infants. These infants are fed with expressed breast milk or preterm formulas of which temperature is not routinely measured. There is limited number of studies about the effect of food temperature on feeding intolerance. Aim: In this study, we aimed to examine the effects of feeds with warm versus room air temperature in preterm infants hospitalized in our newborn intensive care unit. Material-Methods: Infants with a birth weight of ≤1500 g or gestational age ≤ 34 weeks hospitalized in our NICU were included in the study. Infants with gastrointestinal anomalies or genetic anomalies were excluded form the study. The patients were randomly assigned to two different feeding temperature groups. While patients in the cold group were fed at room temperature (22-24°C), patients in the hot group were fed at 32-34°C). Enteral intake, gastric residuals, weight gain, transition time to total enteral feeding, need of medical treatment, weight at discharge and clinical findings were prospectively followed up. Gastric resuals more than half of the enteral intake was considered as significant. Results: Totally, 80 preterm infants (Group 1 fed with 22–24 °C (n=40), group 2 fed with 32–34 °C (n=40)) were prospectively included in the study. There was a slight decrease in gastric residual frequency in patients fed with breast milk in group 2. Apnea was significantly more frequent in Group 1 (p=0.006) and these infants needed more antireflux treatment (p=0.013). During the study, 12 patients were followed up for NEC (Group 1 n=5, Group 2 n=7) (p>0.05). Conclusion: According to our results, warming enteral feeds close to body temperature is encouraging especially due to the decrease in gastric residual frequency, apnea of prematurity and need for antireflux treatment. More studies may confirm positive effect of warm enteral feeds on feeding tolerance in preterm infants. Key words: Prematurity, enteral nutrition, feeding tolerance, temperature