Minimal enteral feeds should be started with expressed human milk as soon as possible after birth at a starting volume of?

• A. 5-10 mL/kg per day
• B. 10-20 mL/kg per day
• C. 20-30 mL/kg per day
• D. 15-25 mL/kg per day

Answer: (B)

Minimal enteral feeds given early aim to gently wake the immature gut while delivering immunologic and nutritional benefits from expressed human milk. The starting volume commonly used is about 10-20 mL per kilogram per day, given in small portions (often every 2-4 hours). Feeds are advanced by roughly 10-20 mL/kg per day as the infant tolerates them, monitoring for signs of intolerance such as distension, residuals, or vomiting. Using expressed human milk is preferred because it reduces the risk of necrotizing enterocolitis and is easier to digest than formula. If tolerance is excellent, progression proceeds toward full feeds appropriate for the infant’s weight and clinical condition.