Enteral feeds for preterm infants should start within how many hours of birth if they are not intubated and not on specific medications?

For preterm infants who are stable, not intubated, and not receiving specific medications that might interfere with feeding, initiating enteral feeds within 6 to 12 hours following birth is recommended. Beginning enteral feeds within this timeframe is essential for several reasons.

Firstly, early feeding is known to support the maturation of the gastrointestinal tract, helping preterm infants establish normal feeding patterns and promoting gut health. It also aids in the development of the enteral feeding tolerance, which is particularly important in preterm infants who often have underdeveloped digestive systems.

Secondly, introducing feeds early can help reduce the risk of complications such as necrotizing enterocolitis (NEC), a serious gastrointestinal condition. There is evidence suggesting that early enteral feeds can contribute to improved outcomes in preterm infants, including better weight gain and shorter hospital stays.

Starting feeds too late—beyond 12 hours—may not be as beneficial and could delay the establishment of appropriate nutrition, which is critical for growth and development. This makes the timeframe of 6 to 12 hours optimal for supporting early nutrition in preterm infants.