Skip to main content
. 2023 Jun 16;2023(6):CD012937. doi: 10.1002/14651858.CD012937.pub3

Parker 2019.

Study characteristics
Methods RCT
Participants 143 infants born at ≤ 32 weeks’ gestation with a birth weight of ≤ 1250 g and were receiving some feeds by 72 hours after birth
Exclusion criteria: congenital or chromosomal abnormalities, including complex congenital heart disease or a gastrointestinal condition
Interventions Gastric residual monitoring group: gastric residuals were aspirated and monitored before each feed. In addition, infants were assessed for other signs such as abdominal distension or tenderness or both, increased abdominal girth, visible bowel loops, emesis and visible blood in the stool
No monitoring of gastric residual group: prefeed gastric residuals were not monitored. Infants were assessed for other signs of NEC or feed intolerance, including abdominal girth monitoring, as described above
Outcomes Primary outcome: 

  • weekly enteral nutrition measured in mL/kg for 6 weeks after birth


Secondary outcomes: 

  • time to reach full enteral feeds (120 mL/kg/day);

  • duration of parenteral nutrition;

  • duration of CVL;

  • parenteral nutrition‐associated liver disease (PNALD);

  • growth indices (weekly weight, head circumference, and length);

  • duration of hospital stay;

  • incidence of feed intolerance (episodes of vomiting and episodes of increased abdominal circumference by > 2 cm during the 6‐week trial);

  • episodes of presumed (treated with antibiotics for ≥ 5 days) or culture‐proven late‐onset sepsis (occurring ≥ 3 days of life); and

  • evidence of stage II or greater NEC. 


Other outcomes included:

  • incidence of intraventricular haemorrhage;

  • death;

  • bronchopulmonary dysplasia (BPD);

  • duration of respiratory support;

  • incidence of ventilator‐associated pneumonia (VAP) incidence of gastric content aspiration (as determined by pepsin level in endotracheal aspirate);

  • occult faecal blood;

  • faecal calprotectin; S100A12;

  • motilin; and 

  • gastrin levels
Notes Feeds were initiated at up to 20mL/kg/d and advanced daily by ≥ 20mL/kg/d to reach a maximum of 120 to 150 mL/kg/day. Only human milk was used for feeding. Mothers' own breast milk was the first choice followed by donor human milk