Abstract
The aim of this study was to observe after following a routine change in the feeding protocol whether the earlier introduction of nutrient supplements improved nutritional outcomes in moderately preterm to late preterm low birth weight (LBW) babies. In this prospective observational study, LBW babies between 31 and 39 weeks’ gestation admitted to a Special Care Nursery were assigned to two groups (F80, n = 45, F160, n = 42) upon commencing nutrient supplement at total fluid intake achievement of 80 or 160 mL/kg/day. Outcomes included weight, protein intake, biochemical markers, feeding intolerance, and length of stay (LOS). F80 nutrient supplements commenced before F160 (2.8 vs. 6.7 days, p < 0.0001) and lasted longer (15.2 vs. 12.2 days, p < 0.03). Weight gain velocity and LOS were similar. F80 mean protein intake during the first 10 days was higher (3.38 vs. 2.74 g/kg/day, p < 0.0001). There were fewer infants with protein intake <3 g/kg/day in the F80 group (8% vs. 65%, p < 0001). F80 babies regained birthweight almost two days earlier (7.5 vs. 9.4 days, p < 0.01). Weight gain Z-scores revealed an attenuation of the trend towards lower weight percentiles in the F80 group. Feeding intolerance was decreased for F80 (24.4% vs. 47.6%, p < 0.03). There were no adverse outcomes. Earlier nutrient supplementation for LBW babies lifts mean protein intake to above 3 g/kg/day and reduces both the duration of post-birth weight loss and incidence of feeding intolerance.
Highlights
In the Special Care Nursery (SCN), the feeding and nutrition of the moderate preterm (32 to 34 weeks’ gestation) to late preterm (34 to 36 weeks’ gestation) low birth weight (LBW) babies are key objectives
While more research has been directed toward the nutritional needs of extremely and very low birth infants (ELBW and VLBW) in the setting of the neonatal intensive care unit (NICU), there has been relatively less research on the nutritional needs of moderate to late preterm infants
This study followed moderately preterm and late preterm LBW neonates during SCN admission between October 2014 and May 2016 at The Northern Hospital (TNH) in Epping, which is an outer suburb of Melbourne, Australia
Summary
In the Special Care Nursery (SCN), the feeding and nutrition of the moderate preterm (32 to 34 weeks’ gestation) to late preterm (34 to 36 weeks’ gestation) low birth weight (LBW) babies are key objectives. While more research has been directed toward the nutritional needs of extremely and very low birth infants (ELBW and VLBW) in the setting of the neonatal intensive care unit (NICU), there has been relatively less research on the nutritional needs of moderate to late preterm infants. The establishment of breastfeeding in the late preterm infant compared to the full-term infant is often problematic due to immaturity and difficulties with latching, sucking, and swallowing [5]. Assessing feeding adequacy requires careful attention via a cue-based approach with an expressed breast milk (EBM) fortifier and preterm formula of potential benefit especially in those babies who are growth retarded and with gestation ages around
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