Australasian neonatal intensive care enteral nutrition survey: Implications for practice

Journal of Paediatrics and Child Health - Tập 49 Số 4 - 2013
Barbara E. Cormack1, John Sinn2, Kei Lui3, David Tudehope4
1Auckland City Hospital, Auckland,#N#New Zealand
2Royal North Shore Hospital, Sydney, New South Wales, Australia
3Royal Hospital for Women, Sydney, New South Wales, Australia
4Mater Health Services, South Brisbane, Queensland, Australia.

Tóm tắt

AimThis survey investigated standardised feeding guidelines and nutrition policy in Australasian neonatal intensive care units and compared these with previously published surveys and international consensus nutrition recommendations.MethodsAn electronic survey on enteral nutrition comprising a wide range of questions about clinical practice was e‐mailed to all 25 Australasian neonatal intensive care unit directors of tertiary perinatal centres.ResultsTwenty‐five surveys were distributed; 24 (96%) were completed. All respondents preferred breast milk as the first feed. For infants <1000 g, 58% started feeds at 1 mL every 4 hours and 83% started enteral feeds on day 0–2 in the absence of contraindications. The identification of bile‐stained gastric aspirates significant enough to withhold feeds varied. Multicomponent breast milk fortifiers were added by 58% when enteral feeds reached 150 mL/kg day, while 21% added these earlier at 120 mL/kg day or less. Iron supplementation was started at 4 weeks by 63% and at 6 weeks by 27%. Only 42% of units had a neonatal dietitian. Of the 24 units who responded, 58% had no written enteral feeding guidelines.ConclusionEnteral nutrition was initiated earlier than in the past. Great variation remains in clinical practices. Nutritional implications are discussed. Standardisation of feeding guidelines and enteral nutrition policy based on current evidence and international consensus nutrition recommendations may be beneficial and should be encouraged.

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Tài liệu tham khảo

10.1542/peds.107.2.270

10.1542/peds.2008-3258

10.1136/adc.2011.212563.7

10.1007/s00431-007-0435-x

Tsang RC, 2005, Nutrition of the Preterm Infant: Scientific Basis and Practical Guidelines

10.1097/MPG.0b013e3181adaee0

Edmond K, 2006, Optimal Feeding of Low‐Birth‐Weight Infants. Technical Review

10.1111/j.1740-8709.2007.00087.x

10.1542/peds.2007-3644

10.1080/jmf.16.5.309.314

Pritchard JA, 1966, Fetal swallowing and amniotic fluid volume, Obstet. Gynecol., 28, 606

10.1042/cs0590317

10.1002/14651858.CD000504.pub3

Tyson JE, 2000, Minimal enteral nutrition for promoting feeding tolerance and preventing morbidity in parenterally fed infants, Cochrane Database Syst. Rev.

Illig KA, 1992, Total parenteral nutrition‐induced changes in gut mucosal function: atrophy alone is not the issue, Surgery, 112, 631

10.1016/S0022-3476(05)81969-9

Berseth CL, 1993, Enteral nutrients promote postnatal maturation of intestinal motor activity in preterm infants, Am. J. Physiol., 264, G1046

10.1111/j.1651-2227.2008.00987.x

10.1016/S0022-3468(98)90352-9

10.1093/ajcn/83.1.155

10.1542/peds.105.2.379

10.1053/adnc.2002.31511

10.1080/14767050802630169

10.1055/s-0029-1214235

10.1136/adc.66.7_Spec_No.805

10.1136/adc.2007.119560

10.1097/00005176-200208000-00008

Leaf A, 2010, Alimentazione del neonato pretermine IUGR: studio multicentrico ADEPT (Abnormal Doppler Enteral Prescription Trial). (Feeding the IUGR premature newborn infant: the multicenter ADEPT study), Minerva Pediatr., 62, 31

10.1136/adc.2009.159129

Gordon M, 2009, Recognition of bilious aspirates in a tertiary neonatal centre, Internet J. Pediatr. Neonatol.

10.1136/bmj.38859.614352.55

10.1111/j.1440-1754.2006.00897.x

KuschelC CormackB MorreauP.Withholding feeds in the NICU. Assessment of Bilious Aspirates and Vomiting. Auckland District Health Board New Zealand 2005.

Ziegler EE, 1976, Body composition of the reference fetus, Growth, 40, 329

10.1046/j.1440-1754.2000.00577.x

FoodWorks [program]. 5 version. New Zealand 2007.

10.1111/j.1651-2227.1996.tb14227.x

10.1097/00005176-200004000-00011

10.1136/adc.2010.204123

10.1007/BF01213376

Hambidge M, 2000, Human zinc deficiency, J. Nutr., 130, 1344S, 10.1093/jn/130.5.1344S

10.1542/peds.102.5.1172

10.1136/adc.2006.099697

10.1038/jp.2009.50

10.1111/j.1651-2227.1990.tb11548.x

10.1542/peds.2004-0911

10.1097/MCO.0b013e3280523aaf

10.1016/S0022-3476(97)70058-1

LaBarre DJ, 1987, Effect of monitored feeding protocol on VVLBW infants [abstract], J. Am. Diet. Assoc., 87, A‐58

10.1016/S0002-8223(98)00378-2

10.1542/peds.111.SE1.e461

10.1016/j.jada.2005.05.012

10.1136/adc.2004.059741

10.1038/jp.2010.185

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Journal of Paediatrics and Child Health

Tập 49 Số 4

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