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Randomized controlled trial : impact of glycerin suppositories on time to full feeds in preterm infants

Khadr, Sophie N and Ibhanesebhor, Samuel E and Rennix, Connie and Fisher, Hazel E and Manjunatha, Chikkanayakanahalli M and Young, David and Abara, Rosemary C (2011) Randomized controlled trial : impact of glycerin suppositories on time to full feeds in preterm infants. Neonatology, 100 (2). pp. 169-176.

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Abstract

Feed intolerance delays achievement of enteral feeding in preterm infants. Parenteral nutrition is associated with cholestasis and increased risk of sepsis. Glycerin suppositories have been used to promote gastrointestinal motility and feed tolerance. Objectives: To investigate whether daily glycerin suppositories (a) reduce the time to full enteral feeding in infants born at <32 weeks’ gestation, and (b) influence feed tolerance, incidence of sepsis or necrotizing enterocolitis, duration of oxygen requirement, growth or age at discharge. Design – prospective open randomized controlled trial; study population – preterm infants stratified into 2 subgroups, 24–27+6 weeks (24–27 weeks + 6 days) and 28–31+6 weeks; intervention – daily glycerin suppository for 10 days from 24 h of age, 250 mg (24–27+6 weeks subgroup) or 500 mg (two 250-mg suppositories; 28–31+6 weeks subgroup); controls – no intervention. The same feeding protocol and departmental guidelines for other aspects of neonatal intensive care were used in all subjects. Analysis was by intention to treat. 54 babies were recruited (31 males), 29 randomized to receive suppositories; 48 achieved full enteral feeds. The median (range) time to full feeds was 1.6 days shorter in intervention group babies than controls, but not statistically significant: 7.4 (4.6–30.9) days versus 9.0 (4.4–13.3) days (p = 0.780; 95