Glycerin suppository for promoting feeding tolerance in preterm very low birthweight neonates: a randomized controlled trial.

OBJECTIVE To compare the efficacy of glycerin suppository versus no suppository in preterm very-low-birthweight neonates for improving feeding tolerance. DESIGN Randomized controlled trial. SETTING Level III neonatal unit from Mumbai, India. PARTICIPANTS 50 very-low-birthweight (birth weight between 1000 to 1500 grams)preterm (gestational age between 28 to 32 weeks) neonates randomized to glycerine suppository (n=25) or no intervention (n=26). INTERVENTION Glycerin suppository (1g) once a day from day-2 to day-14 of life or no suppository, along with intermittent oral feeds and standardized care. PRIMARY OUTCOME Time required to achieve full enteral feeds (180 mL/kg/d). RESULTS Baseline characteristics of neonates like gestational age, birthweight, gender and age at the time of introduction of feeds were comparable in both groups. The mean (SD) duration to reach full enteral feed was 11.90 (3.1) days in glycerin suppository group and was not significantly different (P=0.58) from control group, [11.33 (3.57) days]. Glycerin suppository group regained birth weight 2 days earlier than control group but this difference was not significant (P=0.16). There was no significant difference in duration of hospital stay or occurrence of necrotizing enterocolitis amongst the two study groups. CONCLUSIONS Once daily application of glycerin suppository does not accelerate the achievement of full feeds in preterm very-low-birthweight neonates.