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A ustralasian neonatal intensive care enteral nutrition survey: Implications for practice
Author(s) -
Cormack Barbara,
Sinn John,
Lui Kei,
Tudehope David
Publication year - 2013
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.12016
Subject(s) - medicine , parenteral nutrition , enteral administration , breast milk , neonatal intensive care unit , intensive care , clinical nutrition , clinical practice , breast feeding , pediatrics , intensive care unit , intensive care medicine , nursing , biochemistry , chemistry
Aim This survey investigated standardised feeding guidelines and nutrition policy in A ustralasian neonatal intensive care units and compared these with previously published surveys and international consensus nutrition recommendations. Methods An electronic survey on enteral nutrition comprising a wide range of questions about clinical practice was e‐mailed to all 25 A ustralasian neonatal intensive care unit directors of tertiary perinatal centres. Results Twenty‐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. Conclusion Enteral 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.