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Starting and Increasing Feeds, Milk Tolerance and Monitoring of Gut Health in Significantly Preterm Infants

Lookup NU author(s): Dr Janet Berrington


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© 2022 S. Karger AG, Basel. Approaches to enteral feeding significantly preterm infants' impact short-term outcomes including survival, late-onset sepsis (LOS), and necrotizing enterocolitis (NEC), and neurodevelopmental and later health outcomes. Clinical practice and trial data are dominated by short-term outcomes (NEC and LOS) with limited longer-term outcomes. Strategies maximizing early maternal breast milk (MOM) exposure and duration of MOM use are key given global health benefits of MOM, but few feeding trials use these as outcomes. Current data support colostrum receipt, early introduction, and progression of volumes between 18 and 30 mL/kg/day, without adverse impact on NEC, LOS, or mortality. Little evidence supports choosing between route of gastric tube placement, bolus, or continuous feed delivery. Individual infants may have specific features that require individualized feed management, such as combinations of growth restriction, antenatal blood flow concerns, intensive supportive needs (including inotropes), and large open patent ductus arteriosus, currently poorly represented in feeding trials. Infant tolerance monitoring includes clinical observations (stooling, abdominal size, vomiting) but routine gastric aspiration appears unhelpful. Infants should be monitored biochemically, anthropometrically, and in the future through bedside microbiomics or metabolomics. Units and networks should audit and compare their rates of mortality, NEC, LOS, neurodevelopment, and growth achieved.

Publication metadata

Author(s): Berrington JE

Editor(s): Nicholas D. Embleton, Ferdinand Haschke, Lars Bode

Publication type: Book Chapter

Publication status: Published

Book Title: Strategies in Neonatal Care to Promote Optimized Growth and Development: Focus on Low Birth Weight Infants

Year: 2022

Volume: 96

Pages: 1-12

Print publication date: 28/02/2022

Acceptance date: 02/04/2018

Series Title: Nestle Nutrition Institute Workshop Series

Publisher: Karger

Place Published: Basel


DOI: 10.1159/000519384

PubMed id: 35537421

Notes: 96th Nestlé Nutrition Institute Workshop, May 2021. Session 1: Optimizing Feeding, Nutrition and Growth on the NICU and after Discharge.

Library holdings: Search Newcastle University Library for this item

ISBN: 9783318070330