Gastric Feeding Versus Transpyloric Feeding in Infants with Severe Bronchopulmonary Dysplasia, a Crossover Study

N-of-1 Trial Comparing Prolonged Gastric Feeding to Transpyloric Feeding in Infants with Severe Bronchopulmonary Dysplasia

Hospitalized infants with severe bronchopulmonary dysplasia (BPD) and feeding intolerance will be randomized to 2 weeks of continuous gastric feeding or continuous transpyoloric feeding. Subjects will crossover after 2 weeks and receive 4 weeks of each feeding mode. Respiratory status will be assessed to determine the optimal feeding mode for each infant.

Inclusion Criteria:

• Patients born <32 weeks' gestation
• Currently admitted to the Le Bonheur NICU
• Grad 2 or 3 BPD (positive pressure or intubated at 36 weeks PMA)
• Signs of gastroesophageal reflux, chronic aspiration, or other feeding intolerance.

Exclusion Criteria:

• Known gastrointestinal anomalies
• Unable to tolerate ≥100mL/kg/day enteral feeding
• Congenital anomalies likely to alter feeding techniques
• Surgical feeding tube in place or expected within the next 8 weeks
• Expected to remain hospitalized <8 weeks