Feeding Intolerance and Faecal Calprotectin in Preterm Neonates on 3 Different Feeding Protocols: A Comparative Study | ||
| Al-Azhar Journal of Pediatrics | ||
| Volume 28, Issue 4, October 2025 PDF (1.12 M) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/azjp.2025.456779 | ||
| Abstract | ||
| Background: Feeding intolerance and Necrotizing Enterocolitis (NEC) remain significant challenges in the care of preterm neonates, contributing substantially to morbidity and mortality in these vulnerable preterms. Objective: This study aimed to compare the effects of breast milk, preterm formula, and hydrolyzed formula on feeding intolerance, fecal calprotectin levels and NEC development in preterm neonates. Patients and Methods: This prospective study was conducted over six months in the Neonatal Intensive Care Unit (NICU) at Children's Hospital, Ain Shams University, involving 45 preterm infants. Patients were divided into three groups (n=15 each): Group I (mainly breastfed), Group II (preterm formula with ≤30%breast milk), and Group III (hydrolyzed formula with ≤30% breast milk). Demographic, natal, anthropometric data and abdominal X-ray findings were collected and fecal calprotectin levels were measuredat two points: before initiating enteral feeding and after achieving full enteral intake or upon NEC diagnosis. Faecal Calprotectin was quantified using the fCAL turbo test, a particle-enhanced turbidimetric immunoassay done on cobas c 503 analyzer. Results: Baseline characteristics were comparable across all groups. All groups showed significant increases in abdominal circumference and feeding volume over time, but only Group I (breastfed) demonstrated significant weight gain. Group III (hydrolyzed formula) showed a significant decrease in gastric residuals. Crucially, fecal calprotectin levels were significantly lower in Group I (p=0.016), with a highly significant greater percentage reduction (p=0.007) compared to both formula groups. Calprotectin levels correlated negatively with gestational age and anthropometrics and positively with delayed feeding initiation and meconium passage across groups. Conclusion: Preterm babies who are mainly breastfed are less likely to develop feeding intolerance and NEC. This highlights the crucial anti-inflammatory benefits of breast milk, advocating for its prioritization in preterm infant nutrition. | ||
| Keywords | ||
| Preterm Neonates; Feeding Intolerance; Fecal Calprotectin; Breast Milk; Necrotizing Enterocolitis; Formula Feeding | ||
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