Preterm Infants May Better Tolerate Feeds at Temperatures Closer to Freshly Expressed Breast Milk: A Randomized Controlled Trial.

ABSTRACT

PURPOSE: 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 the temperature is not routinely measured. In this study, we aimed to examine the effects of feeds with warm milk versus room temperature milk in preterm infants. MATERIALS AND METHODS: Infants with a birth weight ≤1,500 g or gestational age ≤34 weeks were included in the study and assigned to two different feeding temperature groups (22-24°C and 32-34°C). Some infants in both groups were exclusively breast milk-fed, and some received breast milk and artificial milk (mixed feeding). Feeding tolerance of infants in both groups and the consequences were evaluated. RESULTS: In total, 80 preterm infants (group 1 fed with milk at 22-24°C, n = 40; group 2 fed with milk at 32-34°C, n = 40) were prospectively included in the study. There was a slight decrease in gastric residual frequency in infants fed with breast milk in group 2. Apnea was significantly more frequent in group 1 (p = 0.006), and these infants needed more anti-reflux treatment (p = 0.013). CONCLUSION: According to our results, warming enteral feeds close to body temperature are encouraging especially due to the decrease in gastric residual frequency, apnea of prematurity, and need for anti-reflux treatment. More studies may confirm the positive effect of warm enteral feeds on feeding tolerance in preterm infants.