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Very low birth weight infant care: adherence to a new nutrition protocol improves growth outcomes and reduces

Beatrice M Stefanescu1, Maria Gillam-Krakauer1, Andrei R Stefanescu2

  • 1Department of Pediatrics, Division of Neonatology, University of New Mexico School of Medicine, 1 University of New Mexico, Albuquerque, NM 87131-0001, USA.

Early Human Development
|February 20, 2016
PubMed

Insights

A nutrition bundle improved growth in very low birth weight (VLBW) infants, reducing complications. This standardized approach enhanced linear and head circumference growth, decreasing postnatal growth restriction.

Area of Science:

  • Neonatalogy
  • Pediatric Nutrition
  • Clinical Pathways

Background:

  • Very low birth weight (VLBW) infants face significant risks of postnatal growth restriction due to challenges in nutrient delivery and illness.
  • Variability in clinical practices can negatively impact growth outcomes in VLBW infants.
  • Integrated clinical pathways offer a structured approach to improve growth and reduce complications.

Purpose of the Study:

  • To evaluate the impact of a comprehensive nutrition bundle on anthropometric parameters in VLBW infants at 36 weeks postmenstrual age (PMA).
  • To assess secondary outcomes including time to enteral feeding, central line duration, and incidence of necrotizing enterocolitis (NEC) and sepsis/sepsis-like episodes.

Main Methods:

  • Implementation of a nutrition bundle with standardized enteral feeding protocols and central line management in July 2012.
  • Study included VLBW infants (<1500 g, <34 weeks gestation) over a 1-year pre- and post-intervention period.
  • Comparison of anthropometric z scores, feeding milestones, central line days, and clinical outcomes between the intervention (Nutrition bundle) and control (Conventional) groups.

Main Results:

  • The Nutrition bundle group showed significantly higher median delta z scores for length and head circumference at 36 weeks PMA compared to the Conventional group.
  • Fewer infants in the Nutrition bundle group experienced severe growth restriction.
  • The intervention group demonstrated significantly shorter times to first and full enteral feedings, reduced central line-days, and decreased incidence of NEC and sepsis/sepsis-like episodes.

Conclusions:

  • A comprehensive nutrition bundle effectively improved linear and head circumference growth in VLBW infants.
  • The standardized approach led to a reduction in postnatal growth restriction and associated comorbidities.
  • Implementation of integrated clinical pathways for nutrition management is beneficial for VLBW infant outcomes.
Abstract

Keywords:
Breast milkGrowthGrowth restrictionNutritionPreterm infants

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