Optimal Neonatal Feeding Intervals Based On Stomach Capacity.pdf

There is insufficient evidence on optimal neonatal feeding intervals, with a wide range of practices. The stomach capacity could determine feeding frequency. A literature search was conducted for studies reporting volumes or dimensions of stomach capacity before or after birth. Six articles were found, suggesting a stomach capacity of 20 mL at birth. This translates to a feeding interval of approximately 1 h for a term neonate. The gastric emptying time for human milk also corresponds to this interval. Larger feeding volumes at longer intervals may be stressful and cause spitting up, reflux, and hypoglycaemia. Outcomes for low birthweight infants could possibly be improved if stress from overfeeding was avoided while supporting the development of normal gastrointestinal physiology. Cycles between feeding and sleeping at 1-h intervals likely meet the evolutionary expectations of human neonates.

Current practice in many health institutions worldwide is that full-term infants should feed every three to four hours. However, there is no evidence to support this practice, and only case series and descriptive studies have been conducted. A search was conducted for research articles covering prenatal or postnatal gastric capacity, volume, or anatomical dimensions. Six studies on foetal and neonatal stomach capacity were identified and are summarized in Table 1.

The stomach capacity of a term neonate is approximately 20 mL, based on the collective evidence from the studies reviewed. Given a stomach size of about 20 mL at birth and the assumption that stomach size should correspond to feeding volume, the viewpoint proposed is that the feeding interval should be approximately one hour for an average-term neonate. Stomach capacity and feed interval should be regarded in the broader context of the newborn, including their primary occupations of sleeping and feeding. The normal sleep cycle of neonates is also approximately 1 h, and both state organization and ingestive behaviours are regulated by the same autonomic nervous system. The synactive model for developmental care includes observations on these behaviours. The autonomic control of the stomach includes a cephalic phase that prepares the stomach for food, followed by a gastric phase. The cues for these phases are regulated by the same autonomic nervous system.