Effect of standardized feeding protocol on nutrient supply and postnatal growth of preterm infants: A prospective study

Khan, Zahra; Morris, Nicholas; Unterrainer, ­Human-Friedrich; Haiden, Nadja; Holasek, Sandra; Urlesberger, Berndt

doi:10.3233/npm-18179

Cited by 11 publications

(11 citation statements)

References 29 publications

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“…This study is a prespecified secondary outcome analysis of a prospective observational study conducted at the Division of Neonatology, Medical University of Graz, Austria (15). Preterm infants born <32 weeks gestation who were admitted to the neonatal intensive care unit between March 2014 and May 2015 were included.…”

Section: Methodsmentioning

confidence: 99%

“…The present analysis and PEA POD measurements were a standard procedure during the period of that nutritional analysis study (15). The study was approved by the ethics committee of the Medical University of Graz, with written parental consent prior to inclusion.…”

Section: Methodsmentioning

confidence: 99%

“…The local feeding protocol of the included preterm infants has previously been described in detail by Khan et al (15). The preterm infants in the present study obtained nutrition according to the ESPGHAN 2010 Guidelines (13,14).…”

Section: Feeding Regimenmentioning

confidence: 99%

“…In the first week after birth, the average macronutrients and energy supply were 2.44 g/kg/day of proteins, 3.39 g/kg/day of lipids, and 72 kcal/kg/day (15). In the second week after birth, the preterm infants already received 3.26 g/kg/day of proteins, 5.60 g/kg/day of lipids, and 120 kcal/kg/day (15).…”

Section: Feeding Regimenmentioning

confidence: 99%

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Extremely Preterm Infants Have a Higher Fat Mass Percentage in Comparison to Very Preterm Infants at Term-Equivalent Age

et al. 2020

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Background: Early nutritional support of preterm infants is important because it influences long-term health and development. Body composition has an influence on cardiovascular disease, metabolic syndrome, and neurocognitive outcome in the long term. Objective: To assess body composition in preterm infants <32 weeks of gestation at term-equivalent age and to analyze the influence of an optimized nutritional approach. Methods: This is a prespecified secondary outcome analysis of a prospective observational study comparing the body composition in regard to gestational age. The preterm infants were classified according to gestational age as extremely preterm infants (<28 weeks gestation at birth) and very preterm infants (≥28 weeks gestation at birth) and according to weight percentile as appropriate for gestational age and small for gestational age. Body composition was determined by air displacement plethysmography using the PEA POD. The preterm infants obtained nutrition according to the ESPGHAN 2010 Guidelines. Results: Seventy-four preterm infants were analyzed. The mean (SD) gestational age was 28.7 (2.4) weeks, and birth weight was 1,162 (372) g. Fat mass percentage was significantly higher in extremely preterm infants in comparison to very preterm infants [17.0, 95% confidence interval (CI) 15.9-18.1 vs. 15.5, 95% CI 14.7-16.2]. There was no significant difference of fat mass percentage according to weight percentiles. Conclusions: Extremely preterm infants had a significantly higher fat mass percentage compared to very preterm infants at term-equivalent age. There was no significant difference of fat mass percentage according to weight percentiles.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Feeding Regimenmentioning

confidence: 99%

Section: Feeding Regimenmentioning

confidence: 99%

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Extremely Preterm Infants Have a Higher Fat Mass Percentage in Comparison to Very Preterm Infants at Term-Equivalent Age

et al. 2020

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“…Feeding performances and growth velocity were strictly monitored during their hospital stay, from birth until discharge. The feeding protocol has previously been discussed in detail by Khan et al .…”

Section: Methodsmentioning

confidence: 99%

Full oral feeding is possible before discharge even in extremely preterm infants

et al. 2018

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Aim: This study described the steps needed to achieve full oral feeding before discharge in a group of very and extremely preterm (EPT) infants. We analysed the effects of oral feeding skills on discharge timing and on weight gain during their neonatal intensive care unit (NICU) stay.Methods: A prospective cross-sectional observational study of 100 infants who were <32 weeks of gestation (GA) was conducted at the Division of Neonatology, Graz, Austria, from March 2014 to February 2015. Patients were stratified into two groups: those who were <28 weeks at birth and those who were 28 weeks and over. Velocity of oral feeding skills attainment and weight gain were analysed.Results: All infants successfully acquired oral feeding skills during hospitalisation. The median GA at which full oral feeding skills were reached was 37 + 1 weeks in EPT and 34 + 5 weeks in very preterm infants. More immature neonates showed worse feeding performances and lower weight increments during oral feeding steps.

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Quality improvement initiative to achieve early enteral feeds in preterm infants at a level IV neonatal intensive care unit

Prasad,

Johnson,

McGuire

et al. 2024

Nut in Clin Prac

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ObjectiveWe report the results of a quality improvement initiative to reduce the time to full enteral feeds and number of central line and parenteral nutrition days in premature infants in a level IV neonatal intensive care unit (NICU) by 20%.Study DesignIn 2020, a multidisciplinary team at our NICU initiated a quality improvement project to improve enteral feeding in infants with a birthweight <1800 g. The key drivers were early donor human milk consent, trophic feeds initiation, and modification of the enteral feeding guidelines. The interventions included prenatal donor human milk consents, mandatory staff education, and NICU newsletter reminders. Retrospective baseline data were collected May 1, 2020, to November 23, 2020, and prospective data were collected November 24, 2020, to September 30, 2022.ResultsSpecial cause variation was detected for time to achieve full enteral feeds, central line days, and parenteral nutrition days with 30%, 44%, and 42% improvements, respectively. There was no increase in feeding intolerance or necrotizing enterocolitis.ConclusionSmall changes in feeding guideline processes improved enteral feedings in preterm infants without increase in morbidities. Our process measures are practical and easy to implement in most NICU settings.

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Effect of standardized feeding protocol on nutrient supply and postnatal growth of preterm infants: A prospective study

Abstract: Provision of aggressive parenteral nutrition during first 3 weeks of life and earlier fortification should be ensured. The use of mother milk fortifier resulted in glucose intake above the ESPGHAN recommendations in later weeks - this needs to be evaluated in future studies.

Cited by 11 publications

References 29 publications

Extremely Preterm Infants Have a Higher Fat Mass Percentage in Comparison to Very Preterm Infants at Term-Equivalent Age

Extremely Preterm Infants Have a Higher Fat Mass Percentage in Comparison to Very Preterm Infants at Term-Equivalent Age

Full oral feeding is possible before discharge even in extremely preterm infants

Quality improvement initiative to achieve early enteral feeds in preterm infants at a level IV neonatal intensive care unit

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