Initiation Time of Trophic Feeding and Associated Factors Among Preterm Neonates Admitted to Neonatal Intensive Care Unit (NICU) of Public Hospitals in Addis Ababa, Ethiopia.

Abstract Background Trophic feeding is the introduction of a minimal volume of enteral nutrition, up to 24 ml/kg/day for the first several days of life. The purpose of this study was to determine the initiation time of trophic feeding and associated factors among preterm neonates admitted to neonatal intensive care units (NICU) in selected public hospitals in Addis Ababa. Patients and Methods: Institution-based prospective follow-up study was conducted among 153 preterm neonates admitted to NICU in selected hospitals from Feb-20 to April 20, 2023. Data were collected using the KoboCollect app and entered in STATA version 14 for cleaning and analysis. The Kaplan-Meier survival curve and Cox proportional hazards models were used for analysis. Result A total of 153 neonates were followed for 6853 person-hours of risk time and 130 (85%) of neonates were initiated trophic feeding. The incidence rate of initiating trophic feeding was 1.9 per 100 person-hours observations with a median time of 41 hours (95% CI: 31–45). Gestational age < 34 weeks (AHR: 0.54, 95% CI: 0.37–0.79), APGAR score at first minute < 7 (AHR:0.4, 95% CI: 0.25–0.65), APGAR score at fifth minute < 7 (AHR:0.51, 95% CI: 0.34–0.79), being small for gestational age (AHR: 0.54, 95% CI: 0.33–0.88), cesarean section delivery (AHR: 0.47, 95% CI: 0.31–0.71), being delivered out of the studied hospitals (AHR: 0.50, 95% CI: 0.30–0.83), having respiratory distress syndrome (AHR: 0.63, 95% CI: 0.43–0.94) and having hemodynamic instability (AHR: 0.46, 95% CI: 0.31–0.68) were statistically significant associated factors for the delay of initiation of trophic feeding. Conclusion In this study, a significant delay in the initiation time of trophic feeding and several predictors were identified. Therefore, health institutions should work on these predictors to shorten the initiation time and reduce complications associated with the delay.