International survey on enteral nutrition, supplementation and probiotic practices for preterm infants
Year: 2026
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: To evaluate enteral feeding practices in preterm infants in neonatal intensive care units (NICUs) in high-income countries across three continents, and compare results with a similar survey 13 years earlier. METHODS: Web-based survey distributed to neonatologists at 258 NICUs across 15 countries in Europe, Australia, New Zealand and Canada, October 2023 and February 2024. Survey domains focused on availability of human milk, onset of enteral feeding, breast milk fortification (BMF), cytomegalovirus (CMV) screening and enteral supplements including probiotics. Results were compared with a similar survey performed in 2010. RESULTS: Replies were received from 185 (72%) NICUs. Access to donor human milk (DHM) was high (91%). Across all NICUs, feeds were started on day 1 in 64%, 73% and 85% among infants born <25, 25-27 and 28-31 weeks' gestation, respectively. Bovine milk-based BMF was routinely used in 88% of NICUs, with large variation in when it was commenced and discontinued. Routine use of human milk-based BMF was uncommon (4%). Maternal CMV status was routinely determined in 33% of all NICUs who then pasteurised or froze milk if the mother was CMV-seropositive. Probiotics were provided in 66% of the NICUs, with large variations in products and birth weight/gestational age criteria. CONCLUSIONS: Compared with our survey from 2010, more NICUs now start feeding preterm infants on day 1, and DHM availability has increased in some countries. Substantial variation remains in the use of BMF, probiotics and CMV screening. A stronger evidence base is needed to update guidelines, aiming ultimately to improve growth and long-term neurodevelopment.
Institutions: University Hospital of North Norway, UiT The Arctic University of Norway, University of Copenhagen, Copenhagen University Hospital, Rigshospitalet, Emma Kinderziekenhuis, Amsterdam University Medical Centers, University of Amsterdam, Universitätsklinikum Würzburg, Hospital Universitario La Paz, Centre Hospitalier Universitaire Vaudois, University of Lausanne, University College Dublin, National Maternity Hospital, University of Calgary, Alberta Children's Hospital Research Institute, O'Brien Institute for Public Health, University of Turku, Turku University Hospital, Karolinska University Hospital, Karolinska Institutet, Unidade Local de Saúde de São José, Hospital de Dona Estefânia, Universidade Nova de Lisboa, Royal Women's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust
Language: English
Topic: Infant Nutrition and Health
Subfield: Nutrition and Dietetics
Field: Nursing
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7128744312