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  • Title: Improving Nutrition Outcomes for Infants < 1500 Grams With a Progressive, Evidenced-Based Enteral Feeding Protocol.
    Author: Thoene MK, Lyden E, Anderson-Berry A.
    Journal: Nutr Clin Pract; 2018 Oct; 33(5):647-655. PubMed ID: 29603412.
    Abstract:
    BACKGROUND: Growth is essential for very low birth weight infants. The purpose of this retrospective chart review was to evaluate the impact of a new standardized, evidenced-based feeding protocol for infants born < 1500 g in correlation with growth and clinical outcomes. METHODS: Growth and nutrition data was reviewed from 2 groups of infants born < 1500 g within a level III newborn intensive care unit (NICU). Epoch 1 infants (N = 32) received care following initial implementation of a standardized enteral feeding protocol. Epoch 2 infants (N = 32) received care following aggressive modification of this initial protocol based on newly available literature that promotes earlier initiation and advancement of enteral feedings. RESULTS: Epoch 2 infants weighed more at 36 weeks (2562 vs 2304 g) with higher discharge weight percentiles (32nd vs 15th percentile). Epoch 2 infants started and achieved full enteral feedings earlier (day of life 1 vs 4; 7 vs 22, P < 0.0001) and required less days of parenteral nutrition (5.5 vs 17.5 days, P < 0.0001), with indwelling central line for parenteral access (6 vs 17.5). There were no differences in retinopathy of prematurity (17% control vs 19% study), oxygen requirement at 36 weeks (22% epoch 1 vs 43%), necrotizing enterocolitis (3% epoch 1 vs 0%), intraventricular hemorrhage grade 3-4, periventricular leukomalacia, or death. CONCLUSION: In this sample of very low birth weight infants, a progressive standardized, evidence-based feeding protocol was associated with improved growth without increased risk for necrotizing enterocolitis.
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