The timing and method of feeding depend on illness severity, clinical stability, and the infant's gestation.
Sick infants
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Significant illnesses include respiratory distress requiring mechanical ventilation, shock, and seizures. These infants require intravenous fluids initially.
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Start enteral feeding at the earliest opportunity once the infant is reasonably stable. The feeding method depends on gestation and clinical condition.
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Many sick infants can receive enteral feeding once hemodynamically stable, before complete recovery.
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Infants receiving mechanical ventilation for respiratory distress can be fed enterally once the acute phase is over.
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Sepsis or asphyxia without shock or NEC does not contraindicate enteral feeding.
Healthy LBW infants
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Initiate enteral feeding immediately after birth using an appropriate feeding method.