Nutrition and Feeding in Infants with Bronchopulmonary Dysplasia after Initial Hospital Discharge: Risk Factors for Growth Failure

Abstract

Objective To identify nutritional risk factors for growth failure in infants with bronchopulmonary dysplasia (BPD) after initial hospital discharge, and to describe growth in and feeding concerns about these infants after discharge to the community. Design A cohort of 40 infants with BPD was followed up for 7 monthly visits after initial hospital discharge. Data on potential risk factors were gathered prospectively. Subjects/setting Forty infants with BPD were recruited from all 4 tertiary-level neonatal intensive care units in the Puget Sound area of Washington. Exclusionary criteria included congenital or chromosomal anomalies, grade IV intraventricular hemorrhage, and drug or alcohol exposure in utero. Main outcome measures Growth failure defined as weight less than the 5th percentile on National Center for Health Statistics growth curves at 2 or more points in time and a decrease in weight-for-age z score during the study period. Statistical analyses performed Relative risk of growth failure with exposure to each risk factor was determined. The χ 2 test was used to measure association between growth and development, and change in z scores was used to examine growth patterns. Results Growth failure occurred in 8 of 40 infants. Twenty-nine of the infants experienced a drop in weight-for-age z score from the initial to the final study visit. Growth failure was associated with low socioeconomic status (relative risk = 4.0, 95% confidence interval = 1.3,12.6), postdischarge days of illness (relative risk = 10.5, 95% confidence interval = 1.4,77.4) and “suspect” development (χ 2=7.12, P=.014). Applications Infants with BPD may benefit from comprehensive postdischarge nutrition and feeding therapy that includes ensuring adequate energy intake, parental support and education, and feeding evaluation and therapy. J Am Diet Assoc. 1998;98:649–656.