Conflicting opinions concerning the optimum age at which to commence feeding premature infants have resulted in either early or late regimens. In order to test the hypothesis that the early administration of fluids to premature babies was beneficial, a controlled study of 50 newborn premature subjects was undertaken. Fluids consisting of 5% dextrose in 0.45% saline were started before the age of 6 hours by constant drip through a nasogastric plastic catheter in 24 subjects selected by a predesigned method using a table of random permutations. The average intake during the test period was 54.5 ml/kg/24 hours. The other 26 control subjects received no fluids until age 36 hours, when both groups were started on formula.
There was no alteration of symptoms of respiratory distress in the group receiving early feedings. One-half of these subjects did not lose weight while being fed the dextrose and saline solution. They promptly lost weight, however, when regular milk feedings were commenced.
The seven infants who died had similar pathologic findings. It was noted that three of the five in the fluid treated group also had pulmonary hyaline membranes. There were no hyaline membranes in the lungs of the two subjects deprived of water.
From this study neither beneficial nor detrimental effects of early feeding could be demonstrated by use of the criteria of dyspnea or mortality. The question of when to start to feed premature babies is still unanswered. There is need for further feeding trials, in which associations among age of commencement, nature of substances fed and the consequent physiologic responses, can be observed.