Weight Gain In Preterm Infants Research Articles

Early aggressive nutrition in the neonate.

1. Patti J. Thureen, MD* 1. 2. *Associate Professor, Department of Pediatrics, University of Colorado Health Sciences Center, Denver, CO. After completing this article, readers should be able to: 1. Describe the possible long-term effects of suboptimal nutrition in preterm infants and critically ill term neonates. 2. Explain why the current standard for postnatal nutrition in preterm infants may not be adequate for postnatal growth. 3. List the the lower limit at which to start intravenous protein delivery in very low-birthweight infants. 4. Characterize the commonly used definition for minimal enteral nutrition. 5. List the advantages of minimal enteral nutrition compared with exclusive total parenteral nutrition for the neonate. Nutritional practices vary dramatically among neonatal intensive care units (NICUs) in the United States. In many institutions, nutrition is introduced only gradually over the first weeks of life because of concerns of nutrient intolerance by the very preterm or ill infant who is fed intravenously and the risk of necrotizing enterocolitis (NEC) in preterm infants who are fed enterally. Often this period of nutritional deficiency is accepted as inevitable in this population. However, such a strategy of cautious nutrition might lead to a period of early malnutrition from which the neonate has a prolonged recovery and may have long-term adverse consequences. In many neonates this period of early nutritional deprivation need not be inescapable. Many neonatologists will consider the early feeding strategies for the NICU population suggested in this article to be somewhat aggressive. The premise for these recommendations for extremely low-birthweight (ELBW) infants is that avoiding early malnutrition has both short- and long-term benefits for the neonate. This strategy involves initiating total parenteral nutrition (TPN) in the first hours after birth and administering it in conjunction with initially small, and then advancing, enteral feedings beginning on the first or second day of life. Use of TPN is a means to achieve rapid, maximal nutrition, and early enteral feedings are designed to prime the gut and …

Sodium supplementation optimizes weight gain in preterm infants

Acta PaediatricaVolume 84, Issue 11 p. 1312-1314 Sodium supplementation optimizes weight gain in preterm infants THERAPEUTIC NOTE M Vanpée, Corresponding Author M Vanpée Pediatric Department, Danderyd Hospital, Stockholm, SwedenM Vanpée, Department of Woman and Child Health, Pediatric Unit, Karolinska Institute, S-112 81 Stockholm, SwedenSearch for more papers by this authorP Herin, P Herin Department of Woman and Child Health, Pediatric Unit, Karolinska InstituteSearch for more papers by this authorU Broberger, U Broberger Pediatric Department, Danderyd Hospital, Stockholm, SwedenSearch for more papers by this authorA Aperia, A Aperia Pediatric Department, Danderyd Hospital, Stockholm, SwedenSearch for more papers by this author M Vanpée, Corresponding Author M Vanpée Pediatric Department, Danderyd Hospital, Stockholm, SwedenM Vanpée, Department of Woman and Child Health, Pediatric Unit, Karolinska Institute, S-112 81 Stockholm, SwedenSearch for more papers by this authorP Herin, P Herin Department of Woman and Child Health, Pediatric Unit, Karolinska InstituteSearch for more papers by this authorU Broberger, U Broberger Pediatric Department, Danderyd Hospital, Stockholm, SwedenSearch for more papers by this authorA Aperia, A Aperia Pediatric Department, Danderyd Hospital, Stockholm, SwedenSearch for more papers by this author First published: November 1995 https://doi.org/10.1111/j.1651-2227.1995.tb13556.xCitations: 10AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume84, Issue11November 1995Pages 1312-1314 RelatedInformation

Energy Expenditure, Lipolysis, and Glucose Production in Preterm Infants Treated with Theophylline

Theophylline is administered to preterm infants with pulmonary disease to improve pulmonary function and reduce apneic episodes. Because it potentially mediates both alpha- and beta-receptor-effector mechanisms, we tested the hypothesis that it increases lipolysis, gluconeogenesis from glycerol, and energy expenditure in 16 preterm infants, eight of whom were treated therapeutically with theophylline for apnea of prematurity (T) and eight of whom were controls (C). Mean +/- SD postnatal ages were 4.8 +/- 1.9 wk (T) and 2.4 +/- 0.9 wk (C) (p < 0.01). Corrected gestational ages were 35 +/- 1.6 wk (T) and 34 +/- 0.5 wk (C) (p = NS). Body weights were 1.69 +/- 0.13 kg (T) and 1.70 +/- 0.23 kg (C) (p = NS). All infants were clinically stable, breathing room air, fed enterally, and receiving no diuretics, steroids, or antibiotics. Lipolysis, hepatic glucose production, and gluconeogenesis from glycerol were measured using [2-13C]glycerol and [6,6-3H2] glucose tracers. Body water and energy expenditure were measured by the 2H2(18)O method. Body water volumes were 68.5 +/- 3.4% body weight (T) and 70.2 +/- 3.4% (C) (p = NS), suggesting fat was 10-13% of body weight in both groups. Mean daily energy expenditure was 65 +/- 22 kcal/kg body weight/d (T) versus 59 +/- 5 kcal/kg body weight/d (C) (p = NS). Between 4 and 6 h after a feeding, glucose production rates were 40.5 +/- 4.3 mumol/kg/min (T) and 37.6 +/- 4.8 mumol/kg/min (C) (p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)

Late metabolic acidosis and poor weight gain in moderately pre-term babies fed with a casein-predominant formula: a continuing need for caution

When our neonatal unit opened in 1984 our formula feeding policy for moderately preterm babies was for casein-predominant rather than "humanized" whey-predominant milk formulae to be given. However, an early cluster of cases of late persistent metabolic acidosis prompted an investigation into the acid-base status and weight gain in preterm infants. This study of 70 healthy, moderately preterm (32-35 weeks) Chinese babies has convincingly shown that a casein-predominant low protein formula is associated with significant metabolic acidosis, persisting sometimes for as long as 8 weeks, and poor weight gain when compared with infants fed on either a humanized or a special low-birthweight formula. This is an important message for the many neonatal units in developing countries where the cost of humanized formulae might initially seem prohibitive, encouraging instead casein-predominant formulae when breast milk is not available. Any additional expense incurred in using humanized formulae will be compensated for by the shortened time spent in hospital.

Effects of Tactile Stimulation on Premature Infant Weight Gain

A study was conducted to determine the effect of continuous tactile stimulation on weight gain in premature infants. Thirty infants made up the sample. The experimental group received continuous tactile stimulation by being placed on a pile decubitus pad for a five-day period. Infants in the control group received routine nursery care. Both groups were weighed daily on the same scale. Analysis of covariance was used to analyze the data, which resulted in a failure to reject the hypotheses of no difference.

Relationships Between Lysozyme Concentration of Human Milk, Bacteriologic Content, and Weight Gain of Premature Infants

SummaryLysozyme concentrations and bacterial colony counts were determined in 399 human milk samples obtained from 42 mothers (18 mothers of term infants, 24 mothers of preterm or small for date neonates). The average lysozyme concentration was 21.39 ± 13.19 mg/L. Lysozyme concentrations were significantly greater in preterm (24.99 ± 15.05 mg/L) than in term milk (14.89 ± 9.83 mg/L) (p &lt; 0.05). Bacterial colony counts did not decline with increasing lysozyme concentration, i.e., no correlation between lysozyme concentration and bacterial count was found. Despite this lack of correlation, a significant correlation between lysozyme concentration and rate of weight gain was observed: the higher the lysozyme concentration, the better the weight gain. The mechanism of this observation remains to be elucidated; a trophic effect of lysozyme is suggested as a possible mechanism.

Relationships between lysozyme concentration of human milk, bacteriologic content, and weight gain of premature infants.

Lysozyme concentrations and bacterial colony counts were determined in 399 human milk samples obtained from 42 mothers (18 mothers of term infants, 24 mothers of preterm or small-for-date neonates). The average lysozyme concentration was 21.39 +/- 13.19 mg/L. Lysozyme concentrations were significantly greater in preterm (24.99 +/- 15.05 mg/L) than in term milk (14.89 +/- 9.83 mg/L) (p less than 0.05). Bacterial colony counts did not decline with increasing lysozyme concentration, i.e., no correlation between lysozyme concentration and bacterial count was found. Despite this lack of correlation, a significant correlation between lysozyme concentration and rate of weight gain was observed: the higher the lysozyme concentration, the better the weight gain. The mechanism of this observation remains to be elucidated; a trophic effect of lysozyme is suggested as a possible mechanism.

Proceedings: Effect of correction of primary late metabolic acidosis on weight gain in premature infants.

<b>87</b> <h3>Objectives</h3> Recently, we confirmed diabetic foot evaluation superiority with dual isotope (DI) SPECT/CT over Tc-99m HDP bone (BS) or In-111 WBC (WBCS) SPECT/CT scans alone. In this study, we investigate if SPECT/CT use is necessary for high accuracy of DI. <h3>Methods</h3> Flow &amp; blood pool imaging were followed by WBC reinjection &amp; DI BS &amp; WBCS planar (PL) &amp; SPECT/CT acquisitions. Tc-99m sulfur colloid/In-111 WBC (step 2 DI) SPECT/CT was obtained in 8 patients (pt) with suspected mid/hindfoot osteomyelitis (OM). DI PL, SPECT &amp; SPECT/CT were separately reviewed by 2 observers for lesion (LS) location, confidence (uncertain, certain), diagnosis (Dx) &amp; Dx confidence based on each review. Final Dx was determined as OM, soft tissue infection (STI), combined OM/STI or other pathology by surgical/pathological &amp;/or up to 24 months follow-up. <h3>Results</h3> Of 61 pt, 50 had confirmed Dx. Final Dx prediction by SPECT/CT was higher than SPECT or PL DI, assessed by Lambda (0.74, 0.46, 0.16) &amp; error reduction % (70%, 45%, 23%), respectively. Of 111 LS seen by all images, Dx confidence was higher (p &lt; 0.001) in SPECT/CT than SPECT or PL DI. Compared with SPECT/CT, LS location was incorrect in 29% SPECT &amp; 32% PL DI. All 8 pt with Step 2 DI SPECT/CT had improved Dx, achieving a superior accuracy (Lambda 0.89, error reduction 86%), which included 1 false negative (chronic OM) &amp; 2 false positive (1 gouty arthritis, 1 without pathology) Dx. <h3>Conclusions</h3> In DI imaging of diabetic foot, SPECT/CT considerably improves detection &amp; discrimination of STI &amp; OM while providing precise anatomic localization. When needed, step 2 DI SPECT/CT can yield additional information for a more definitive Dx.

The relation of plasma tyrosine level to weight gain of premature infants

Protein and caloric intake, changes in weight, and plasma tyrosine levels were studied in 85 babies of low birth weight (less than 2,500 grams) during the first 3 weeks of life. There was no evidence that babies who developed elevated plasma tyrosine levels gained less weight than those with low plasma tyrosine levels.

Role of dietary protein, fat and electrolyte levels in rates of weight gain of premature infants

Normal human plasma has been found to contain several y-globulins of small molecular weight: 3S Yl-globulins with a molecular weight of 25,000, 2S y~-globulins of a size similar to tha t of the 3S yl-globulins and y-globulins with a sedimentation constant of 0.5S. These y-globulins appear to be immunoehemically related to each other, to normal urine y-globulin, to Bence Jones protein and to L chains of 7S y~-globulin, but immunoelectrophoresis and double diffusion in agar reveals significant antigenic differences between these proteins. Peptide analysis also reveals marked differences between each of these y-microglobulins, 7S y.o-globulins, yln-gtobutins, 19S ya-globulins, and urine y-globulins, indicating that the microglobulins are not derived one from the other or from the larger y-globulins. The y-microglobulins isolated from normal plasma do not seem to contain significant amounts of antibody against diphtheria or tetanus toxins, measles, or poliomyelitis viruses, and their functions remain unknown.

The Weight Gain of Premature Infants

The Weight Gain of Premature Infants