***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Forty three infants under 1400 g were fed by a bolus nasogastric , continuous nasogastric , or transpyloric route . There were more complications with transpyloric feeding and no identifiable benefits in the growth rate , oral energy input , or chosen biochemical indices of nutrition .  Bolus or continuous nasogastric feeds rather than transpyloric are better routine methods in infants of low birth weight We compared nasojejunal with nasogastric tube feeding in 18 healthy low-birth-weight infants from eight to 15 days of age . NJ-fed infants had significantly more stools and excreted significantly more fat and potassium in their stools . Growth and weight gain did not differ between the groups during the study period . Future use of NJ feeding in LBW infants should take into account the possibility of malabsorption associated with this technique There were 53 appropriate for gestational age infants with a birth weight of less than 1,700 gm admitted to the Children 's Hospital in Denver who were r and omly assigned to two groups for gavage or transpyloric ( nasojejunal ) feedings . The two groups were not significantly different in terms of gestational age , birth weight , and morbidity . No significant differences were observed for caloric intake after 4 days of age , growth parameters ( weight , length , and head circumference ) , serum total protein levels , feeding-related complications , duration of intravenous fluid supplementation , and length of hospitalization . The results indicate that intermittent gastric gavage feedings are as efficacious as transpyloric feedings in supplying nutrition to the low birth-weight infant . Because of inherently greater risks , costs , radiation , and requisite personnel expertise , transpyloric feedings can not be recommended as a routine method of feeding for the low birth-weight infant OBJECTIVE A relationship between  gastroesophageal reflux ( GER ) and apnea of prematurity ( AOP ) has long been suspected but is difficult to prove because most GER in this age group is nonacidic and thus undetectable by pH monitoring , the current st and ard for GER detection . The new multiple intraluminal impedance ( MII ) technique allows pH-independent reflux detection via changes in impedance caused by a liquid bolus inside the esophagus . We used this technique to investigate whether there is a temporal relationship between GER and AOP and whether GER occurs predominantly before a cardiorespiratory ( CR ) event . METHODS Nineteen infants with AOP ( median gestational age at birth : 30 weeks ; range : 24 - 34 ; age at study : 26 days [ 13 - 93 ] ) underwent 20 6-hour recordings of MII , breathing movements , nasal airflow , electrocardiogram , pulse oximeter saturation , and pulse waveforms . MII signals were analyzed , independent of CR signals , for reflux episodes ( RE ) , defined as a fall in impedance in at least the 2 most distal channels . CR signals were analyzed for CR events , ie , apneas of > /=4-second duration , desaturations to < /=80 % , and falls in heart rate to < /=100/min . A temporal relationship between an RE and a CR event was considered present if both commenced within 20 seconds of each other . RESULTS There were 2039 apneas ( median : 67 ; range : 10 - 346 ) , 188 desaturations ( 6 ; 0 - 25 ) , 44 bradycardias ( 0 ; 0 - 24 ) , and 524 RE ( 25 ; 8 - 62 ) . The frequency of apnea occurring within + /- 20 seconds of an RE was not significantly different from that during reflux-free epochs ( 0.19/min [ 0.00 - 0.85 ] vs 0.25/min [ 0.00 - 1.15 ] ) ; the same was true for desaturations and bradycardias . Also , RE occurred similarly often within 20 seconds before as after an apnea ( 2 ; 0 - 14 vs 1 ; 0 - 17 ) . A minority of apneas ( 3.5 % ) was associated with an RE reaching the pharyngeal level ; of these , significantly more ( 45 vs 26 ; median : 1 ; 0 - 10 vs 1 ; 0 - 7 ) occurred after rather than before an RE . CONCLUSION Both CR events and GER were common in these infants but , with few exceptions , did not seem to be temporally related One hundred successive infants weighing less than 1500 g at birth were allocated alternately to intermittent nasogastric or continuous nasoduodenal feeding regimens .  Eighty were appropriate for gestational age , and of these 25 fed successfully by nasogastric tube and 16 tolerated nasoduodenal feeding until 1600 g. No significant differences in either calorie intake or growth rates were identified throughout the seven weeks of the study . Because of the increased complexity and radiological exposure involved with feeding transpylorically , nasogastric feeding may be preferred as a method of feeding the low birthweight infant Continuous nasojejunal and intermittent nasogastric feedings were compared in a controlled prospect i ve study in 21 low-birth-weight infants . The groups were comparable in regard to period of gestation , birth weight , head circumference , and clinical findings . Cumulative weight gain , caloric and fluid intake , percent weight lost , blood chemistry values , and complications were used in evaluating the two groups . Upon completion of the 21-day study , N/J infants were found to have had statistically better weight gain , caloric intake , and fluid intake ( p = 0.05 - 0.001 ) during the early part of the study . Weight loss was less in the N/J group ( p less than 0.01 ) . Neither group had abnormalities of blood chemistry or significant complications . It is concluded that N/J feeding in the low-birth-weight neonate is a safe , effective means of early nutritional intake , with advantages most pronounced during the first two weeks of life 
    Output:
    
There were not any statistically significant differences between the groups in the mean body weight or occipitofrontal head circumference at three months or at six months corrected age .
REVIEW ER 'S CONCLUSIONS We did not find any evidence of benefit , but did find evidence of adverse effects , of transpyloric feeding in preterm infants .
Feeding via the transpyloric route can not be recommended for preterm infants