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Executive summary: evaluation of the evidence to support practice guidelines for nutritional care of preterm
Daniel J Raiten1, Alison L Steiber2, Rosa K Hand2
1Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD; and raitend@mail.nih.gov.
Insights
Developing evidence-based guidelines for preterm infant nutrition is crucial due to the lack of current standards. The Pre-B Project aims to create these guidelines by addressing nutrient specifications, feeding issues, and outcomes for premature infants.
Area of Science:
- Neonatology
- Nutritional Science
- Public Health
Background:
- Preterm birth is a major global health concern with no established nutritional care guidelines for affected infants.
- A consortium of leading health organizations initiated the Pre-B Project to address this critical gap.
Purpose of the Study:
- To establish a foundation for evidence-informed nutritional care guidelines for preterm infants.
- To identify research priorities for improving the health and development of preterm infants through nutrition.
Main Methods:
- Convened a consortium including major pediatric and nutrition organizations, and government agencies.
- Established four working groups focusing on nutrient specifications, enteral feeding, gastrointestinal/surgical issues, and outcome assessments.
- Summarized findings from a workshop and working group reports to inform guideline development.
Main Results:
- Identified key areas for systematic review to inform new practice guidelines.
- Developed a research agenda to address knowledge gaps in preterm infant nutrition.
- Compiled reports on nutrient needs, feeding practices, clinical issues, and outcome measures.
Conclusions:
- The Pre-B Project provides a comprehensive overview and framework for developing essential nutritional care guidelines for preterm infants.
- The project's outputs will guide the Academy of Nutrition and Dietetics' Evidence Analysis Library in creating new, evidence-based recommendations.
Abstract:
Preterm birth (infants born at <37 wk of gestational age) is a significant clinical and public health challenge in the United States and globally. No universally accepted practice guidelines exist for the nutritional care of preterm infants. To address the current state of knowledge and to support systematic reviews that will be used to develop evidence-informed guidance, a consortium consisting of the American Academy of Pediatrics, the ASN, the American Society for Parenteral and Enteral Nutrition, the Academy of Nutrition and Dietetics, the Food and Drug Administration, the CDC, the USDA/Agricultural Research Service (USDA/ARS), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development/NIH initiated the Pre-B Project. The project included the constitution of 4 thematic working groups charged with the following tasks: 1) develop a series of topics/questions for which there is sufficient evidence to support a systematic review process to be conducted by the Academy of Nutrition and Dietetics' Evidence Analysis Library (EAL), leading to the development of new guidelines for nutritional care of preterm infants, and 2) develop a targeted research agenda to address priority gaps in our understanding of the role of nutrition in the health and development of preterm/neonatal intensive care unit infants. This review consists of a project overview including a summary of a workshop hosted by the USDA/ARS Children's Nutrition Research Center and summary reports of the 4 working groups established to address the following themes: 1) nutrient specifications, 2) clinical/practical issues in enteral feeding, 3) gastrointestinal and surgical issues, and 4) current standards for assessing infant feeding outcomes. These reports will serve as the basis for the ultimate guideline development process to be conducted by the Academy of Nutrition and Dietetics' EAL.
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