Remarks

• The recommendation is conditional on shared decision-making with parents; this includes informing parents about the benefits and risks and the need for further research.
• In making this decision, the GDG considered that the harms from responsive feeding (i.e. poor weight gain) outweighed the benefits (i.e. decreased length of hospital stay).
• Most data were about infants born before 34 weeks’ gestation, so recommendations could not be made for infants born at or after 34 weeks’ gestation.
• The included trials used a range of different feeding schedules and it was not possible to recommend a particular schedule. The GDG suggests 2–3 hourly scheduled feeding may be used for infants born before 34 weeks’ gestation as this is a commonly used and feasible schedule.
• All studies were in hospitalized infants, so the GDG could not make a recommendation on feeding outside the hospital.
• Nurturing care and responsive caregiving are critical to the well-being of every preterm and LBW infant and should be implemented regardless of the type of feeding regime.