Near-infrared spectroscopy is a promising non-invasive technique for monitoring the effects of feeding regimens on the cerebral and splanchnic regions.

The effects of different milk and, or, administration regimens on cerebro-splanchnic perfusion are still a matter of debate. We investigated the effects of the bolus administration of breast milk or formula on cerebro-splanchnic oximetry, function and perfusion, assessed by near-infrared spectroscopy (NIRS).This observational study of 30 infants fed with breast (n=15) or formula (n=15) milk, and matched for gestational age and birth weight, was carried out in the neonatal intensive care unit of the C Arrigo Children's Hospital, Alessandria, Italy, a tertiary level referral centre, from October 2015 to December 2016. NIRS monitoring parameters, such as cerebral and splanchnic oximetry, fraction of tissue oxygen extraction and the cerebral-splanchnic ratio, were recorded before, during and after feeding.Breast milk led to a significant increase in cerebro-splanchnic oximetry and tissue oxygen extraction (p<0.001) during and after feeding and the cerebro-splanchnic perfusion ratio was significantly higher (p<0.001) in the breast than formula group.Our study results suggest that breast milk was better tolerated than formula, requiring lower energy expenditure and lower cerebro-splanchnic haemodynamic redistribution. The findings could prompt investigations using NIRS as a promising non-invasive tool for cerebral and splanchnic longitudinal monitoring during neonatal feeding. This article is protected by copyright. All rights reserved.