Reducing time to initiation and advancement of enteral feeding in an all-referral neonatal intensive care unit

Objective:decrease time to enteral feeding initiation and advancement.study design:in our all-referral neonatal intensive care unit, we developed an evidence-based guideline addressing feeding initiation and advancement. during 6 months before and 7 months after guideline implementation, we measured time to initiate feeding, time to 100 ml/kg/day of feeding, gastric residual measurement frequency, and incidence of necrotizing enterocolitis (balancing measure).result:two hundred twenty-three infants were studied. time from admission to feeding initiation was shorter after guideline implementation (mean 0.5 days [95% ci: 0.4–0.7] vs. 1.1 days [95% ci: 0.7–1.5], p = 0.01). time from admission to 100 ml/kg/day feeding was also shorter (3.6 days [95% ci: 2.8–4.4] vs. 6.2 days [95% ci: 4.4–8.1], p = 0.01). after guideline implementation, routine gastric residual measurements were discontinued.conclusion:after implementation of an enteral feeding guideline, which included discontinuation of routine gastric residual assessment, we observed a faster initiation of enteral feeding and shorter time to reach 100 ml/kg/day.