High versus standard volumes of feeds for preterm or low birth weight infants

Abiramalatha T, Thomas N, Gupta V, Viswanathan A, McGuire W

Review question

Does giving preterm or low birth weight infants more milk than is usually given promote growth without causing feeding problems?


Infants born very early (preterm) or very small (low birth weight) need extra nutrients for growth compared to bigger or more mature infants. One way to deliver extra nutrition is to give infants more milk than usual ("high-volume feeds"), typically more than 200 mL per kilogram per day. Although giving high volumes of milk to preterm or low birth weight infants might increase growth rates, concerns include that infants may not tolerate high-volume feeds and may experience side effects including severe bowel problems. We have looked for evidence from clinical trials that assessed whether high-volume feeds are beneficial or harmful for preterm or low birth weight infants.

Study characteristics

Through literature searches up-to-date until Novebember 2016, we found only one small randomised controlled trial (with 64 very low birth weight infant participants) that addressed this question.

Key results

Very low birth weight infants who receive more milk than standard volumes gain weight more quickly during their hospital stay. We found no evidence suggesting that giving infants high volumes of milk causes feeding or gut problems, but this finding is not certain.


Available evidence is insufficient to support or refute the use of high-volume feeds in preterm or low birth weight infants. High-volume feeds might increase the rate of weight gain, but more trials are needed to confirm this finding and to examine whether high-volume feeds cause any problems for preterm or low birth weight infants.

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