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Extremely low birthweight infants: how neonatal intensive care unit teams can reduce postnatal malnutrition and prevent growth retardation
Author(s) -
Loÿs ClaireMarie,
MaucortBoulch Delphine,
Guy Brigitte,
Putet Guy,
Picaud JeanCharles,
Haÿs Stéphane
Publication year - 2013
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.12092
Subject(s) - medicine , head circumference , pediatrics , neonatal intensive care unit , parenteral nutrition , gestational age , malnutrition , low birth weight , enteral administration , birth weight , neonatology , pregnancy , genetics , biology
Aim To evaluate the impact of an improved nutritional policy for extremely low birthweight ( ELBW ) infants on nutritional deficits and postnatal growth. Method We compared two groups of 37 ELBW infants, born before and after the introduction of an improved nutritional policy in A pril 2006. Group A (born 2005 to early 2006) and group B (born 2009) stayed in a French neonatal intensive care unit ( NICU ) for at least 7 weeks. Optimal energy and protein intakes were 120 and 3.5 g/kg/day, respectively, and used to calculate cumulative deficits. Delta z‐scores for weight, length and head circumference were calculated between birth and 36 weeks of postmenstrual age ( PMA ). The improved nutritional policy focused on earlier and higher parenteral intake of lipids and proteins, earlier and higher human milk fortification and earlier transition to preterm formula. Results The two groups did not differ in gestational age and birthweight. However, protein and energy deficits were significantly reduced in group B . Between birth and 36 weeks of PMA , delta z‐scores were significantly reduced for length (p = 0.012) but not for weight (p = 0.09) or head circumference (p = 0.83). Conclusion Higher parenteral intake and close attention to enteral feeding reduced nutritional deficits and linear growth restriction in infants admitted to a French NICU .