Dawn V Y Ng1,2, Joan Brennan-Donnan3, Sharon Unger4,5,6, Nicole Bando2, Sharyn Gibbins7, Andrea Nash8, Alex Kiss9,10, Deborah L O'Connor1,2. 1. 1 Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada. 2. 2 The Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada. 3. 3 Department of Clinical Dietetics, The Hospital for Sick Children, Toronto, Ontario, Canada. 4. 4 Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada. 5. 5 Department of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada. 6. 6 Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada. 7. 7 Department of Professional Practice, Trillium Health Partners, Mississauga, Ontario, Canada. 8. 8 Sunnybrook Health Sciences Center Neonatal Intensive Care Unit, Toronto, Ontario, Canada. 9. 9 Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada. 10. 10 Sunnybrook Research Institute, Toronto, Ontario, Canada.
Abstract
BACKGROUND: Emerging evidence suggests intakes of protein and energy as early as the first week of life in preterm very low birth weight (VLBW) infants are associated with improved neurodevelopment. In response, many neonatal intensive care units (NICUs) have launched new, more aggressive early feeding guidelines. The aim of this study was to evaluate enteral and parenteral energy and macronutrient intakes during the first postnatal week in VLBW infants admitted to NICUs that have introduced more aggressive early feeding guidelines. MATERIALS AND METHODS: Estimated energy and macronutrient intakes were prospectively collected from VLBW infants fed exclusively mother's own milk and/or parenteral nutrition and compared with expert recommendations. Days to reach full enteral feeds (150 mL/kg/d) and discharge anthropometrics were examined. RESULTS: By days 6 and 7, median protein and lipid intakes, respectively, reached recommended values (3.5 and 3.0 g/kg/d). However, by day 8, many infants remained below recommended intakes for protein (34%), lipid (34%), carbohydrate (68%), and energy (71%). Late-onset sepsis was associated with a decreased likelihood of reaching full enteral feeds on any given day (hazard ratio, 0.2; 95% confidence interval, 0.1-0.5; P ≤ .0009). There was no significant relationship between week 1 nutrient intakes and anthropometrics at discharge. CONCLUSION: Despite the introduction of more aggressive early feeding guidelines and improved energy and nutrient intakes compared with literature values, many VLBW infants remain below recommended nutrition goals in the first week.
RCT Entities:
BACKGROUND: Emerging evidence suggests intakes of protein and energy as early as the first week of life in preterm very low birth weight (VLBW) infants are associated with improved neurodevelopment. In response, many neonatal intensive care units (NICUs) have launched new, more aggressive early feeding guidelines. The aim of this study was to evaluate enteral and parenteral energy and macronutrient intakes during the first postnatal week in VLBW infants admitted to NICUs that have introduced more aggressive early feeding guidelines. MATERIALS AND METHODS: Estimated energy and macronutrient intakes were prospectively collected from VLBW infants fed exclusively mother's own milk and/or parenteral nutrition and compared with expert recommendations. Days to reach full enteral feeds (150 mL/kg/d) and discharge anthropometrics were examined. RESULTS: By days 6 and 7, median protein and lipid intakes, respectively, reached recommended values (3.5 and 3.0 g/kg/d). However, by day 8, many infants remained below recommended intakes for protein (34%), lipid (34%), carbohydrate (68%), and energy (71%). Late-onset sepsis was associated with a decreased likelihood of reaching full enteral feeds on any given day (hazard ratio, 0.2; 95% confidence interval, 0.1-0.5; P ≤ .0009). There was no significant relationship between week 1 nutrient intakes and anthropometrics at discharge. CONCLUSION: Despite the introduction of more aggressive early feeding guidelines and improved energy and nutrient intakes compared with literature values, many VLBW infants remain below recommended nutrition goals in the first week.
Entities:
Keywords:
energy; enteral nutrition; lipids; macronutrients; parenteral nutrition; protein
Authors: Michelle R Asbury; Sharon Unger; Alex Kiss; Dawn V Y Ng; Yunnie Luk; Nicole Bando; Rosine Bishara; Christopher Tomlinson; Deborah L O'Connor Journal: Am J Clin Nutr Date: 2019-12-01 Impact factor: 7.045
Authors: Julie Sato; Marlee M Vandewouw; Nicole Bando; Dawn V Y Ng; Helen M Branson; Deborah L O'Connor; Sharon L Unger; Margot J Taylor Journal: Brain Commun Date: 2021-04-01
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