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Drug Dosing: Infants and Children

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Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
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Enteral nutrition encompasses various methods of delivering nutrition directly to the gastrointestinal (GI) tract, bypassing traditional oral intake. It is particularly beneficial for patients who cannot eat by mouth but have a functioning digestive system. Key methods include nasointestinal feeding, gastrostomy, and jejunostomy, each suited to different clinical scenarios based on the patient's needs and condition.
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Related Experiment Video

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A Do-it-yourself System for Scheduled Feeding of Laboratory Rodents in Their Home Cage
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Responsive versus scheduled feeding for preterm infants.

Julie Watson1, William McGuire

  • 1Sheffield Hallam University, Sheffield, UK.

The Cochrane Database of Systematic Reviews
|October 14, 2015
PubMed
Summary

Responsive feeding for preterm infants may help them achieve oral feeding earlier, but evidence is limited. More research is needed to confirm benefits for infant growth and hospital stay duration.

Area of Science:

  • Neonatal care
  • Pediatric nutrition
  • Evidence-based medicine

Background:

  • Responsive feeding, based on infant cues, may improve preterm infant outcomes and parental satisfaction.
  • Scheduled interval feeding is a common alternative practice in neonatal intensive care units.

Purpose of the Study:

  • To compare responsive feeding with scheduled interval feeding in preterm infants.
  • To assess effects on infant growth, hospital stay duration, and parental satisfaction.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs) and quasi-RCTs.
  • Searches included Cochrane Neonatal Review Group, CENTRAL, MEDLINE, EMBASE, and CINAHL databases.
  • Data extraction and risk of bias assessment performed independently by two reviewers.

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Main Results:

  • Nine RCTs with 593 infants were included; trials were generally small with methodological weaknesses.
  • Responsive feeding showed a trend towards slower weight gain but reduced time to full oral feeding.
  • No strong or consistent effect found on overall hospitalisation duration; parental views were not reported.

Conclusions:

  • Current data lack strong evidence for responsive feeding's impact on key preterm infant outcomes.
  • Some evidence suggests earlier transition to oral feeding with responsive feeding, but requires cautious interpretation due to trial limitations.
  • A large, high-quality RCT is necessary to confirm findings and explore other outcomes.