414 Impact of 2016 all-wales neonatal feeding policy on growth velocity. (17th August 2022)

• Record Type: Journal Article
• Authors: Abelian, Artur; Ptyjda, Piotr
• Is Part Of: Archives of disease in childhood. Volume 107(2022)Supplement 2
• Page Start: A152
• Page End: A152
• Publication Date: 2022-08-17
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2022-rcpch.247
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Aims: This study examined the impact of the 2016 All Wales neonatal feeding policy (AWNF) on postnatal growth velocity (PGV). Methods: All babies treated on the neonatal unit for at least two weeks within 18 months prior and after the implementation of AWNF policy were included. Babies were weighed twice weekly. A two-point average weight model was used to calculate PGV in gram/kg/day: GV=[1000(Wn -Wn-1 )]/{(Dn -Dn-1 )[(Wn +Wn-1 )/2]}, where W is weight and D is day of life. The Mann-Whitney test was used for statistical analysis. Results: There were 90 and 72 babies in the pre and post AWNF policy groups, respectively. From birth to discharge, PGV was similar (7.6 vs 8.1; p=0.147). Once birth weight (BWt) was regained, PGV was greater in the AWNF group (13.9 vs 15.9; p=0.009; figure 1 ). There were no significant differences in days to regain BWt and days to discharge after regaining BWt. Across all gestations, AWNF policy was associated with a reduced use of intravenous fluids and with fewer days of volumes >150 ml/kg/day. The duration of the period of NBM, the use of breast milk (BM), BM fortifier, formula, parenteral nutrition, and time to full feeds were similar and so were the incidence of necrotizing enterocolitis and raised CRP. Babies <32 week gestation had a significantly shorter period of NBM and attained full feeds faster with AWNF policy. Conclusion: The 2016 All Wales neonatal feeding policy was associated with a small, but significant increase in PGV once BWt was regained. However, given that GV rates of closer to 18 gram/kg/day are considered more advantageous for optimal growth and development (reference), the findings are of concern. This study authors call for designation of GV as a key performance indicator of the neonatal care.