The decision regarding how to feed must also be made: continuous versus bolus feeding. The preferred method is controversial. Some clinicians feel that continuous feedings are better tolerated while others feel that bolus feedings are more physiologic. In studies, bolus feedings have been associated with improved gastric emptying, and more mature intestinal motility patterns. It is difficult to compare feeding tolerance between continuous and bolus feeds due to differences in the criteria used. Comparison feeding studies have found fewer gastric residuals in those infants given bolus feedings than those fed continuously. A more recent study has found that feeds given as a slow bolus, over 2 h, resulted in a normal duodenal motility pattern, suggesting that some infants may benefit from slow intermittent feedings. Regardless of the method chosen, if an infant does not tolerate one method it may be beneficial to try a different one.
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