To the Editor.—

In a recent issue of Pediatrics, Caple et al reported on a randomized, controlled trial of slow versus rapid feeding volume advancements in appropriate-for-gestational-age infants between 1000 and 2000 g at birth. The authors presented findings that are in good agreement with prior studies on the same subject. Unfortunately, long-term outcome measures have not been assessed thus far. Shortening the period of intravenous nutrition may decrease the rate of neonatal nosocomial bacteremia, and neonatal infection is known to carry an increased risk of mortality, growth delay, and poor neurodevelopmental prognosis.4,5  The potential of improving the outcome by a simple modification in feeding strategy, therefore, is tempting. However, the possible benefit must outweigh any associated adverse effects. We cannot agree with the suggestion that speeding up enteral feeding advancements would be a safe practice. As yet, the effect of rapid...

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