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Study flow diagram.
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Figure 1

Study flow diagram.

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Risk of bias summary: review authors' judgements about each risk of bias item for the included study.
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Figure 2

Risk of bias summary: review authors' judgements about each risk of bias item for the included study.

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Forest plot of comparison: 1 High‐volume vs standard‐volume feeds, outcome: 1.1 Weight gain (g/kg/d).
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Figure 3

Forest plot of comparison: 1 High‐volume vs standard‐volume feeds, outcome: 1.1 Weight gain (g/kg/d).

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Forest plot of comparison: 1 High‐volume vs standard‐volume feeds, outcome: 1.2 Feed intolerance.
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Figure 4

Forest plot of comparison: 1 High‐volume vs standard‐volume feeds, outcome: 1.2 Feed intolerance.

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Forest plot of comparison: 1 High‐volume vs standard‐volume feeds, outcome: 1.3 Necrotising enterocolitis.
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Figure 5

Forest plot of comparison: 1 High‐volume vs standard‐volume feeds, outcome: 1.3 Necrotising enterocolitis.

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Comparison 1 High‐volume vs standard‐volume feeds, Outcome 1 Weight gain (g/kg/d).
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Analysis 1.1

Comparison 1 High‐volume vs standard‐volume feeds, Outcome 1 Weight gain (g/kg/d).

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Comparison 1 High‐volume vs standard‐volume feeds, Outcome 2 Feed intolerance.
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Analysis 1.2

Comparison 1 High‐volume vs standard‐volume feeds, Outcome 2 Feed intolerance.

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Comparison 1 High‐volume vs standard‐volume feeds, Outcome 3 Necrotising enterocolitis.
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Analysis 1.3

Comparison 1 High‐volume vs standard‐volume feeds, Outcome 3 Necrotising enterocolitis.

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Summary of findings for the main comparison. High‐volume feeds vs standard‐volume feeds for preterm or low birth weight infants

High‐volume feeds vs standard‐volume feeds for preterm or low birth weight infants

Patient or population: preterm or low birth weight infants
Setting: neonatal care facilities
Intervention: high‐volume feeds
Comparison: standard‐volume feeds

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect
(95% CI)

No. of participants
(studies)

Quality of the evidence
(GRADE)

Risk with standard‐volume feeds

Risk with high‐volume feeds

Weight gain (g/kg/d)

Mean weight gain was 18.7 g/kg/d

Mean weight gain was 6.2 g/kg/d higher
(2.71 higher to 9.69 higher)

‐

61
(1 RCT)

⊕⊕⊝⊝
LOWa,b

Feed intolerance

Study population

RR 1.81
(0.89 to 3.67)

61
(1 RCT)

⊕⊕⊝⊝
LOWa,b

258 per 1000

467 per 1000
(230 to 947)

Necrotising enterocolitis

Study population

RR 1.03
(0.07 to 15.78)

61
(1 RCT)

⊕⊝⊝⊝
VERY LOWa,c

32 per 1000

33 per 1000
(2 to 509)

*Risk in the intervention group (and its 95% CI) is based on assumed risk in the comparison group and relative effect of the intervention (and its 95% CI).

CI: confidence interval; RCT: randomised controlled trial; RR: risk ratio.

aDowngraded for risk of bias (lack of blinding).

bDowngraded for imprecision.

cDowngraded (by 2) for serious imprecision.

Figuras y tablas -
Summary of findings for the main comparison. High‐volume feeds vs standard‐volume feeds for preterm or low birth weight infants
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Table 1. Typical energy and protein content of human milk or formula

per 100 mL

Expressed breast milk

(EBM)

EBM

+ Fortifier

Term formula

Preterm formula

Energy (kCal)

67

74 to 80

67

80

Protein (g)

1.2 to 1.7

2.0 to 2.5

1.5

2.4
Figuras y tablas -
Table 1. Typical energy and protein content of human milk or formula
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Comparison 1. High‐volume vs standard‐volume feeds

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Weight gain (g/kg/d) Show forest plot

1

61

Mean Difference (IV, Fixed, 95% CI)

6.20 [2.71, 9.69]

2 Feed intolerance Show forest plot

1

61

Risk Ratio (M‐H, Fixed, 95% CI)

1.81 [0.89, 3.67]

3 Necrotising enterocolitis Show forest plot

1

61

Risk Ratio (M‐H, Fixed, 95% CI)

1.03 [0.07, 15.78]
Figuras y tablas -
Comparison 1. High‐volume vs standard‐volume feeds
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