A standardized feeding protocol ensured recommended nutrient intakes and prevented growth faltering in preterm infants < 29 weeks gestation. (February 2023)

• Record Type: Journal Article
• Authors: Rossholt, Madelaine Eloranta; Bratlie, Marianne; Wendel, Kristina; Aas, Marlen Fossan; Gunnarsdottir, Gunnthorunn; Fugelseth, Drude; Stiris, Tom; Domellöf, Magnus; Størdal, Ketil; Moltu, Sissel Jennifer
• Is Part Of: Clinical nutrition ESPEN. Volume 53(2023)
• Page Start: 251
• Page End: 259
• Publication Date: 2023-02
• Subjects: Standardized feeding protocol -- Growth -- Macronutrients -- Body composition -- Nutrition -- Preterm infants; Nutritionally induced diseases -- Periodicals; Metabolism -- Disorders -- Periodicals; 616.39005
• DOI: 10.1016/j.clnesp.2022.12.024
• Languages: English
• ISSNs: 2405-4577

Abstract

Summary: Background &amp; aims: Nutrition is a cornerstone of postnatal care to prevent compromised growth and support short- and long-term health outcomes in preterm infants. We aimed to evaluate nutritional intakes and growth among infants &lt;29 weeks gestation after implementation of a standardized feeding protocol. Methods: This is an observational cohort secondary analysis of data from the ImNuT study (Immature, Nutrition Therapy, NCT03555019). To reduce variations in nutritional practice and ensure accommodation to current guidelines, we developed a standardized feeding protocol. Detailed information on actual nutritional intakes, growth and biochemistry was prospectively collected and assessed from birth to 36 weeks postmenstrual age (PMA). Results: Median (range) gestational age and birth weight were 26 +6 (22 +6 -28 +6 ) weeks and 798 (444–1485) g. Energy and macronutrient intakes progressively increased from birth through transition to exclusive enteral feeds. Parenteral nutrition was weaned at median (IQR) day 11 (9, 14) when nutritional requirements were met by exclusively enteral feeds. Infants exhibited a median (IQR) weight loss of 7.8% (5.7, 11.6) and regained birth weight by day 8 (7, 11). Average velocity in weight, length and head circumference from birth to 36 weeks PMA were in accordance with target growth rates; median (IQR) 15.8 (14.7, 17.7) g/kg/d, 1.1 (0.98, 1.3) cm/week and 0.82 (0.83, 0.89) cm/week. At 36 weeks PMA, only 3% of infants exhibited moderate growth faltering (decline in weigh-for-age z score &gt;1.2 from birth), and none severe. Conclusions: In infants &lt;29 weeks gestation, the standardized feeding protocol was well tolerated. Nutrient intakes and growth were close to recommendations.