Nasogastric vs Orogastric Feeding in Stable Preterm (£32 Weeks) Neonates: A Randomized Open-Label Controlled Trial.

BACKGROUND: Optimal route of tube feeding in preterm babies is not known.

OBJECTIVES: To compare the frequency of bradycardia and desaturation episodes/hours in hemodynamically stable preterm neo-nates (≤32 wk gestational age) fed by nasogastric vs orogastric route.

DESIGN: Randomized controlled trial.

PARTICIPANTS: Hemodynamically stable preterm neonates (≤32 wk gestational age) requiring tube feeding.

INTERVENTIONS: Nasogastric vs orogastric tube feeding.

PRIMARY OUTCOME: Number of episodes of bradycardia and desaturations/hour.

METHODS: Eligible preterm neonates fulfilling the inclusion criteria were enrolled. Each episode of insertion of a nasogastric tube or orogastric tube was labelled as a feeding tube insertion episode (FTIE). FTIE lasted from the time of insertion of tube till the time tube needed to be changed. Reinsertion of the tube in same baby was taken as a fresh FTIE. 160 FTIEs were evaluated during the study period, 80 FTIEs each in babies with gestational age <30 weeks and ≥30 weeks. Number of episodes of bradycardia and desaturation per hour were computed using records in the monitor till the time tube was in situ.

RESULTS: The mean episodes of bradycardia and desaturations/hour [mean difference (95% CI) 0.144 (0.067-0.220); P<0.001] were higher in FTIE by nasogastric as compared to the oro-gastric route.

CONCLUSION: Orogastric route may be preferable to the nasogastric route in hemodynamically stable preterm neonates.