Nasogastric or Orogastric Feeding in Stable Preterm (≤32 Weeks) Neonates, which one should you prefer?

The optimal route of tube feeding in preterm babies has yet to be discovered. A recent study compared the frequency of bradycardia and desaturation episodes/hours in hemodynamically stable preterm neonates (≤32 wk gestational age) fed by nasogastric vs orogastric route. It looked for the number of episodes of bradycardia and desaturations/hour. 

The study labeled each insertion episode of a nasogastric tube or orogastric tube as a feeding tube insertion episode (FTIE), which lasted from the time of insertion of the tube until the tube needed to be changed. Reinserting the tube in the same baby was considered a fresh FTIE. The study evaluated 160 FTIEs, 80 FTIEs each in babies with gestational age <30 weeks and ≥30 weeks. 

The study observed that the mean episodes of bradycardia and desaturations/ hour were higher in FTIE by nasogastric than the oro-gastric route, which indicates that the Orogastric route may be preferable over the nasogastric route in hemodynamically stable preterm neonates.

Gupta NP et al., Nasogastric vs Orogastric Feeding in Stable Preterm (≤32 Weeks) Neonates: A Randomized Open-Label Controlled Trial. Indian Pediatrics. 2023;60:726:730