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Published on: November 20, 2015
Early growth of very low birth weight infants
1Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, P.O. Box 20956-00202, Nairobi, Kenya.
Insights
Early growth in very low birth weight (VLBW) infants is crucial for later outcomes. Preterm formula and reduced neonatal illness improved growth, highlighting the need for optimized feeding and care strategies.
Area of Science:
- Neonatalogy
- Pediatric Growth and Development
- Public Health Nutrition
Background:
- Early growth in very low birth weight (VLBW) infants is a predictor of later health outcomes.
- Optimizing VLBW infant growth is of significant interest, especially in resource-limited settings.
- Growth parameters can guide follow-up care selection for high-risk infants.
Purpose of the Study:
- To characterize early growth patterns in a cohort of VLBW infants.
- To identify factors associated with suboptimal growth in this population.
Main Methods:
- A cross-sectional survey design was employed.
- The study was conducted at Kenyatta National Hospital, Nairobi, Kenya.
- Data were collected from 175 neonatal survivors.
Main Results:
- Significant neonatal illnesses affected 62.3% of infants; 36.6% were small for gestational age.
- By term, only 18.9% to 28% reached the 3rd percentile for weight, length, and head circumference.
- Feeding with preterm formula and absence of neonatal morbidity were associated with better growth (P < 0.001).
Conclusions:
- Mean neonatal growth across all anthropometric measures was below expected standards.
- Less than 30% of VLBW infants achieved the 3rd percentile for weight, length, and head circumference by term.
- Milk choice and neonatal morbidity significantly influenced growth trajectories.
Background:
Early growth in very low birth weight (VLBW) infants has been found predictive of their later outcomes. This has led to increased interest in establishing measures to optimise such growth. In facilities without the resources required to undertake long-term audits for all the high risk infants they graduate, these growth parameters may also be used as selection criteria for those meriting such follow up reducing costs.
Objectives:
To describe early growth patterns among a cohort of VLBW infants and determine some of the factors associated with poor growth among them.
Design:
Cross section survey.
Setting:
Kenyatta National Hospital, Nairobi, Kenya.
Subjects:
One hundred and seventy five neonatal survivors.
Results:
Of the 175 infants recruited, the male/female ratio was 4:6, sixty four (36.6%) were intrauterine growth retarded while significant illnesses during the neonatal period were reported in 109 (62.3%). Forty seven percent of the infants had been fed on exclusive breast milk, 33% on mixed feeds while 20% received exclusive preterm formula. The mean neonatal weight gain for the whole cohort was 13.5 (3.9) g/kg/day, length of 0.34 (0.11) cm/week and head circumference of 0.32 (0.71) cm/week. By term only 33 (18.9%), 37 (21.1%) and 48 (28%) had reached the expected (the 3rd percentile) weight, length and head circumference respectively. Sixty percent of the infants gained weight at <15 g/kg/day while 70% and 78% grew in head circumference and length at < 0.5 cm/week respectively. At term weight, head and linear growth faultering were recorded in 81%, 72% and 79% respectively. The factors that were associated with better growth at this stage included feeding on preterm formula (P < 0.001) and absence of neonatal morbidity (P < 0.001). Infants who were appropriate for gestational age at birth also had better catch up growth at term compared to those born small for gestation (P < 0.001) but their neonatal growth itself was not significantly better.
Conclusion:
The mean neonatal growth in all anthropometric measures was less than expected and by the time of their expected delivery, less than 30% of these infants had reached the 3rd percentile of the expected measurement in all the three growth parameters. Choice of milk and neonatal morbidity influenced these growth patterns.
Recommendations:
Routine fortification of mother's milk or addition of preterm formula and reorganised care of sick newborns is recommended to improve early growth.
