Macdonald 1992.

Methods	Randomised. No Stratification. Blindness of randomisation ‐ Yes. Blindness of intervention ‐ No. Complete follow‐up ‐ No. Blinding of outcome measurement ‐ Can't tell.
Participants	43 infants randomised. 9 post‐randomisation exclusions. 34 infants analysed. Inclusion: Infants < 1400 g. Exclusion: Infants who received expressed breast milk, major congenital malformations, developed hydrocephalus, and if there was intrauterine viral infections.
Interventions	Milk feeding started on day 2 of life with 1 mL/hr of SMA low birthweight formula (Wyeth). Increased 0.5 to 1.0 mL/hr until tolerating 150 mL/kg/day (supplemented with total parenteral nutrition). Unclear frequency of bolus feeding, frequency of increase in feeds, equipment for delivery of continuous feeds. Selected method used until infant attained weight of 1600 g. No energy supplements during study period.
Outcomes	Growth rate including weight gain (grams/week), length gain (mm/week), and occipitofrontal circumference (mm/week), and triceps and quadriceps skinfold thickness, oral energy input, days to full feedings, and chosen biochemical indices (e.g., alkaline phosphatase, urea, albumin, prealbumin, and transferrin). Complications: extra abdominal radiographs, proved aspiration, NEC (proved and probable ‐ ?used Bell's staging), septicaemia, gastric bleeding.
Notes	No sample size calculation. Did not exclude SGA infants. Feeding intervention not described in detail. 5 exclusions in transpyloric group, 1 in continuous group and 3 in bolus group. Report pooled standard deviations for days to full feedings (awaiting mean and standard deviation). Extra abdominal radiographs (n=31) were performed for transpyloric tube placements. Aspiration (1 in continuous group) occurred when babies were over 1600 grams, hence were being fed by bolus nasogastric route. Gastric bleeding ( 1 in bolus group) occurred before milk feedings were started. Staphylococcus epidermidis ‐ 1 case in each group ‐ unclear if this was during study period or during length of stay in NICU. Sample size for each group obtained from author.
Risk of bias
Bias	Authors' judgement	Support for judgement
Allocation concealment (selection bias)	Low risk	On day 2 the feeding route was determined for each baby by opening a sealed envelope.
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Caregivers not blinded as would not be feasible.
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Enrolled 13 babies in the continuous feeding method group but only 12 completed the study as one infant was transferred to another hospital at age two weeks of life. Three of the 15 infants enrolled in the bolus feeding method group died within the first week of life, before milk feedings were established and were therefore excluded from the analysis.