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Table 1 Recommend enteral feeding protocol at the two groups

From: Early versus delayed enteral nutrition for neonatal hypoxic-ischemic encephalopathy undergoing therapeutic hypothermia: a randomized controlled trial

Content

EEN group

DEN group

Initiation time of enteral feeding

Feed if medically feasible during TH and rewarming

Feed if medically feasible after TH

Feeding delivery method

Oral feeding intermittent feeding every 3 hours (20 ~ 30 min) or nasogastric tubes feeding bolus every 3 hours (30 minutes-1 hour) if infants unable to start oral feeds after evaluation of ability for sucking and swallowing daily

Same

Feeding type of milk at initiation a

(1) Breast milk or common formula b if mothers` milk cannot be available

(2) Breast milk or deep hydrolyzed protein milk if mothers` milk cannot be available when infants developed FI (second choice)

Same

Volume of initiation enteral feeding

10 ~ 20 ml/kg/d

Same

Speed of feeding advancement a

(1) 10 ~ 20 ml/kg/d after starting feeds for 3 days and the maximum speed is 30 ml/kg/d (first choice)

(2) 5 ~ 10 ml/kg/d for 3 days and the maximum speed is 20 ml/kg/d (second choice) when infants developed FI

Same

Frequency of feeding advancement a

(1) Advancement of milk volume each 1 day up to the goal of full enteral feeds (first choice)

(2) A short fast if necessary, then advancement of milk volume each 1 ~ 2 days up to the goal of full enteral feeds (second choice) when infants developed FI

Same

Goal of full enteral feeds

120 ml/kg/d

Same

Maximum feeds a

(1) 150 ~ 160 ml/kg/d (first choice) (2) 140 ~ 150 ml/kg/d (second choice) when infants developed FI

Same

  1. EEN Early enteral nutrition, DEN Delayed enteral nutrition, TH Therapeutic hypothermia, FI Feeding intolerance
  2. a All second choice should be only given to infants when clinicians consider them may occur feeding intolerance who cannot continue first choice
  3. b Common formula is defined as formula for term and near term infants (GA ≥ 35 weeks) containing energy as 67 ~ 68 kcal per each 100 ml