Premature babies to benefit from UHDB-led national trial
Neonatal clinicians from the University Hospitals of Derby and Burton (UHDB) are leading a national trial investigating the best way to feed premature babies.
The FEED1 trial will involve around 40 hospitals across the UK and will test the benefits of introducing milk at the earliest opportunity to babies born between 10 and 7 weeks prematurely.
Around 2,000 babies born between 30 and 33 weeks and their families will take part in the clinical study over the next four-and-a-half years, including at the neonatal units at both the Royal Derby Hospital and Queen’s Hospital Burton.
Most premature babies are currently fed intravenously and when stable are only given small amounts of milk through a feeding tube into their stomach, with the milk then being slowly increased until they are fully milk fed.
The £1.6 million NIHR-funded study is being led by neonatal experts from UHDB and the University of Nottingham and will instead investigate the benefits of introducing milk earlier.
Leading the work, Dr Shalini Ojha, Neonatal Consultant at UHDB and Associate Professor of Neonatology at the University of Nottingham, said: “We want to find out if babies born between 30 and 33 weeks can be safely fully milk fed from the day they are born and if avoiding giving them fluids through a drip can reduce infections and help them go home sooner. We also aim to help mothers to start expressing breast milk as soon as possible after the birth. We will give this milk to the baby first and then give extra milk if needed.
“We also want to gather more robust evidence about the risk of infection and gut problems in babies who have earlier milk feeding. Simultaneously, we will find out more about parents’ feelings about how their baby is fed and the impact of premature birth on breast-feeding.”
Around 8% of babies in the UK are born prematurely and, of these, 12% are born between 30 and 33 weeks into the pregnancy.
Neonatal doctors have traditionally been wary of feeding premature babies with full milk straight after birth because of a potentially life-threatening gut condition called necrotising enterocolitis (NEC).
However, previous evidence suggests that, in babies who are in a stable condition, larger milk feeds can be successfully given within 48 hours of birth without increasing the risk of NEC.
Introducing milk feeds earlier in this group of babies who are relatively stable could have many benefits, including the nutrients and protective antibodies of breast milk.
It could also mean the families can be reunited sooner and it may reduce the demand for neonatal cots, which are in short supply.
Babies included in the research will either receive normal feeding intravenously from birth and gradual introduction of milk feeds at a later stage, or receive milk feeds via a feeding tube from birth.
The amount of milk given will be increased over a few days and the babies in this group will get all of their fluids as milk, unless they are struggling with this and showing signs of sickness.
The FEED1 trial also involves teams at the Dalhousie University Nova Scotia, Canada, University of York, Bradford Teaching Hospitals NHS Foundation Trust, Imperial College London, University Hospital Southampton NHS Foundation Trust and the University of Warwick.