Two-Hourly versus Three-Hourly Feeding in Very Low-Birth-Weight Infants: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Objective This study aimed to systematically review and meta-analyze the benefits and side effects of 3-hourly versus 2-hourly feeding intervals in very low-birth-weight (VLBW) infants. Study Design Database search include PubMed and Cochrane CENTRAL databases from inception until March 3, 2019. The author extracted the data from included studies and used Cochrane-GRADE approach to assess the quality of the evidence. Results Seven studies—four randomized controlled trials (RCTs) and three observational studies—involving 952 infants were included in the review. The pooled analyses of RCTs showed no significant differences in the outcomes: time to reach full enteral feeding, necrotizing enterocolitis, feed intolerance, and hypoglycemia. Infants fed 3-hourly regain birth weight earlier than infants fed 2-hourly (3 RCTs; 350 participants; mean difference [95% confidence interval] −1.12 [−2.16 to −0.08]; I2 = 0%; p = 0.04). The evidence was downgraded to low quality due to risk of bias and imprecision for all outcomes. Two studies found a subgroup of infants, younger and smaller, reach full enteral feeds earlier when fed 2-hourly compared with 3-hourly. Conclusion Low-quality evidence suggests feeding 3-hourly is comparable to 2-hourly feeding in VLBW infants. However, extremely low-birth-weight infants reach full enteral feeds earlier when fed 2-hourly compared with 3-hourly. Further, sufficient powered trials are needed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.031 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.026 | 0.039 |
| Bibliometrics | 0.007 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".