What is a goal of initiating minimum enteral feeds early in preterm neonates?

• A. Prevent gut atrophy
• B. Delay weight gain
• C. Increase risk of NEC
• D. Avoid fortification

Answer: (A)

Starting tiny amounts of enteral nutrition in preterm infants serves to prime the gut and keep the intestinal lining healthy even when full feeds aren’t yet possible. This approach preserves mucosal mass and barrier function, promotes maturation of the gut, and supports normal motility and bile flow. By maintaining a functional gut, you reduce disuse atrophy from minimal feeding and parenteral nutrition, which helps when advancing to full feeds and can lower complications related to gut immaturity. The goal isn’t primarily to speed weight gain, and modern practice does not aim to increase NEC risk by starting small feeds; rather, early trophic feeds are used to support gut health and readiness for full feeding. Fortification is a separate step used later to meet nutritional needs as feeds are advanced.