Early enteral feeding in high-risk preterm infants

This article describes the challenge of feeding extremely preterm infants in the context of immature gut development. The pathogenesis of necrotising enterocolitis (NEC) is explored. Aspects of early enteral feeding are discussed – including when to start, the role of ‘minimal enteral feeding’ and how to advance feeds. Preterm growth-restricted infants born after abnormal antenatal Doppler blood flow velocities are a particularly high-risk group and are discussed in detail. An on-going randomised controlled trial (ADEPT) which is trying to establish when milk feeds should best be introduced in these babies is described.