Background: Feeding is a major element of care for very low birth weight neonates. To grow and develop normally, they must have full enteral fed. Rapidly full enteral feeding conflicts with the physiologic immaturity of the gastrointestinal function with the occurrence of various comorbidities in the neonatal period. In the contrast, delayed full enteral feeding also resulted in physical and neurological sequels. This requires determination of time to full enteral feeding and identification of predictors among very low birth weight neonates.

Objective: To determine the time to full enteral feeding and predictors among very low birth weight neonates admitted at Felege Hiwot Comprehensive Specialized Hospital

Methods: An institutional-retrospective follow-up-study design was conducted among 332 very low birth weight neonates from July 1, 2018, to June 30, 2021. Samples were selected through computer generating simple random sampling method and the data were entered into Epi data version 4.6 and then exported to STATA version 16 for analysis. Kaplan Meir with log-rank test were used to test for the presence of difference in survival among predictor variables. Model goodness-of-fit and assumptions were checked by Cox Snell residual and global test respectively. Variables with P-value < 0.25 in the bi-variable analysis were fitted to the multivariable Cox-proportional hazard model. Finally, the adjusted hazard ratio (AHR) with 95 % CI was computed and variables with a p-value less than 0.05 in the multivariable Cox-regression analysis were considered as significant predictors of time to full enteral feeding.

Result: A total of 332 neonates were followed for 2132 person-days of risk time and 167 (50.3%) of very low birth weight neonates were started full enteral feeding. The overall incidence rate of full enteral feeding was 7.8 per 100 person-day observations. The median survival time was 7 days. Very low birth weight neonates delivered from Pregnancy-induced-hypertension-free mothers (AHR: 2.1, 95% CI: 1.12, 3.94), gestational age of ≥33 weeks (AHR: 5, 95% CI: 2.29, 11.13), kangaroo mother care initiated (AHR: 1.4, 95% CI: 1.01, 2.00), avoid prefeed residual aspiration (AHR: 1.42, 95% CI: 1.002-2.03) and early enteral feeding (AHR: 1.5, 95% CI: 1.03, 2.35) were significant predictors of full enteral feeding.

Conclusion: According to this study, the time to full enteral feeding was relatively short. Therefore, the health care professionals should give emphasize to full enteral feeding and try to tackle the hindering factors to save the lives of VLBW neonates

Key words: Full enteral feeding, time to full enteral feeding, very low birth weight and neonate