Singh 2018.

Methods	RCT
Participants	Infants with birth weight 1500 to 2000 g and postnatal age < 48 hours who required gavage feeds were included. Exclusion criteria were perinatal asphyxia (cord blood gas or first blood gas after birth with pH < 7.0 or base excess > –16 mmol/L and Apgar score < 5 at 10 minutes), major congenital malformations/surgical conditions that could interfere with feeding, and severe growth restriction (defined as birth weight below the third percentile)
Interventions	Routine assessment of gastric residual was done in both groups Intervention group: Only the quality of gastric residual was assessed. A maximum of 0.5 mL of gastric contents was aspirated before each feed. If the residual was haemorrhagic or was repeatedly bilious (more than 1 time) with or without vomiting or abnormal abdominal examination, feed interruption was done. The volume of gastric residual was not assessed Control group: Both volume and quality of gastric residual were assessed. The entire volume of gastric residual was aspirated before every feed. If the aspirate was > 50% of feed volume or > 3 mL, whichever was greater, feeds were withheld. Also if the aspirate was bloody or bile stained, feeds were withheld
Outcomes	Primary outcome: Time to reach full enteral feeding ≥ 120 mL/kg/d Secondary outcomes: Time to regain birth weight, time to regain 120% of birth weight, incidence of late‐onset culture‐proven sepsis (≥ 72 hours), NEC (Bell stage ≥ 2), number of occasions feedings were discontinued for > 24 hours or were not increased for > 24 hours
Notes	Feeds were started on day 1 or later, once the infant was haemodynamically stable. Feeds were started at 3 mL every 3 hours and were increased by 3 mL every 9 hours in infants with birth weight 1500 to 1750 g. For infants with 1751 to 2000 g birth weight, feeds were started at 6 mL every 3 hours and were increased by 3 mL every 6 hours. Infants were fed breast milk if available and preterm formula after parental consent was obtained when breast milk was not available. Feeds were fortified when enteral feeds of 150 mL/kg/d were achieved
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	The randomisation sequence was computer generated and permuted, even numbered; randomly varying block sizes were generated with a 1:1 allocation ratio
Allocation concealment (selection bias)	Low risk	The allocation sequence was concealed using serially numbered opaque sealed envelopes
Blinding of participants and personnel (performance bias) All outcomes	High risk	Unmasked trial
Blinding of outcome assessment (detection bias) All outcomes	High risk	Unmasked trial
Incomplete outcome data (attrition bias) All outcomes	Low risk	All 87 randomised infants were included in the analysis
Selective reporting (reporting bias)	Low risk	Study protocol had been published. All proposed outcomes were reported
Other bias	Low risk	Nil