Feeding issues in preterm infants

Cooke, R. J.; Embleton, ND

doi:10.1136/fn.83.3.f215

Cited by 56 publications

(47 citation statements)

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“…In other words, the chance of reaching a normal weight decreases as the time to achieve a normal growth rate increases 2,41,42,[45][46][47] . On the other hand, Shan et al 32 associated EUGR with an increase in gestational age, which agrees with our results.…”

Section: Discussionmentioning

confidence: 99%

Extrauterine growth restriction: Universal problem among premature infants

et al. 2016

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Objective: To analyze the growth rate of premature infants in the first weeks of life and factors associated with extrauterine growth restriction. Methods: This is a cross-sectional study of 254 premature infants in a neonatal intensive care unit conducted from January 1, 2008 to December 31, 2010. Infants who died or had malformations incompatible with life were excluded. Median weight curves according to gestational age were constructed for the first four weeks of life. The Fenton growth chart calculations provided the weight Z-scores. Extrauterine growth restriction was defined as corrected weight-for-age Z-score ≤-2. Perinatal, morbidity, and health care variables were analyzed. The Poisson regression model yielded the prevalenceratios . Associations between extrauterine growth restriction and the perinatal, morbidity, and care variables were investigated. Poisson regression controlled possible confounding factors. Results: The frequency of extrauterine growth restriction was 24.0%. Most (85.0%) small-for-gestational-age infants developed extrauterine growth restriction; 55.3% of extrauterine growth restriction cases involved small-for-gestational-age infants. Premature infants with gestational age >32 weeks did not recover the median birth weight until the third week of life and had a higher frequency of small-for-gestational-age. The Z-scores of non-small-for-gestational-age infants decreased more after birth than those of small-for-gestational-age infants. extrauterine growth restriction was associated with small-for-gestational-age (PR=6.14; 95%CI=3.33-11.33;p <0.001) and time without enteral diet (PR=1.08; 95%CI=1.04-1.13; p =0.010). Conclusion: Extrauterine growth restriction occurs in premature infants of all gestational age. The participation of small-for-gestational-age and nutritional practices in its genesis is noteworthy. We suggest prospective studies of all premature infants. The implementation of best care practices, individualized for small-for-gestational-age infants, to improve nutrient supply can minimize the problem.

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Section: Discussionmentioning

confidence: 99%

Extrauterine growth restriction: Universal problem among premature infants

et al. 2016

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“…Therefore greater emphasis has been placed on early aggressive nutritional care of these babies in order to prevent postnatal growth retardation. A number of investigators have suggested that parenteral nutrition should be initiated as early after birth as possible and parenteral amino acids be administered at 3-3.5g·kg -1 ·d -1 in order to mimic protein accretion during fetal life (5)(6)(7)(8)(9)(10)(11)(12). Only few studies have examined the safety of early and aggressive administration of parenteral amino acids to low birth weight infants.…”

Section: Introductionmentioning

confidence: 99%

Parenteral Amino Acid and Metabolic Acidosis in Premature Infants

Jadhav

Parimi

Kalhan

2007

J Parenter Enteral Nutr

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OBJECTIVE: Aggressive parenteral nutrition including amino acids is recommended for low birth weight infants to prevent energy and protein deficit. Their impact on acid-base homeostasis has not been examined. PATIENTS AND METHODS:We investigated the impact of dose and duration of parenteral amino acids, with cysteine, on acid-base parameters in 122 low birth weight infants. Premature infants <32 weeks, <1850g and receiving parenteral amino acids at 1.5g·kg -1 ·d -1 for an extended period (>24h), or 3g·kg -1 ·d -1 for a short (5h), extended (24h) or for prolonged (3-5 days) duration were included in the study. Data were obtained at age 0-3 days (n=43) or when clinically stable, age 3-5 days (n=49). Data from thirty infants matched for birth weight, and gestational age and receiving parenteral nutrition during the first five days after birth were also obtained. Acidosis was defined as pH<7.25. RESULTS:Acidosis was evident in all infants between 2 and 5 days after birth. Infants with large patent ductus arteriosus (PDA) exhibited significantly (p<0.05) lower pH early, had higher blood urea nitrogen levels (26 ± 9 vs. 18+8 mg/dl, p<0.05) and had greater weight loss (∼17% of birth weight), when compared with babies without PDA. Gestational age, weight loss and patent ductus arteriosus accounted for 65% of variance in acidosis. CONCLUSIONS:Low birth weight infants develop metabolic acidosis between 2-5 days after birth irrespective of dose and duration of parenteral amino acid administration.. Careful management of parenteral fluids and co-morbidities may lower the incidence of acidosis and promote protein accretion.Précis-The association between early parenteral amino acid administration at 1.5 and 3.0g·kg -1 ·d -1 and blood acid base status was examined in 122 low birth weight infants. The data show that all LBW infants develop metabolic acidosis independent of amino acid dose between 2-5 days after birth, which is exaggerated by associated co-morbidities.

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“…The postnatal development of premature infants is critically dependent on an adequate nutritional intake that mimics a similar gestational stage to which the foetus would be exposed if still in the uterus [5].…”

Section: Introductionmentioning

confidence: 99%

“…Recommended intakes are commonly interrupted for clinical reasons, and very-low-birthweight (VLBW) infants develop major deficits in caloric intakes during initial hospital stay that are not recovered by the time of hospital discharge [5].…”

Section: Introductionmentioning

confidence: 99%