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Transitioning Preterm Infants From Parenteral Nutrition: A Comparison of 2 Protocols

Malki Miller1,2, Keyur Donda2, Alok Bhutada2

  • 11 Department of Nutrition, Maimonides Infants and Children's Hospital, Brooklyn, New York, USA.

JPEN. Journal of Parenteral and Enteral Nutrition
|August 20, 2016
PubMed

Insights

Optimizing parenteral nutrition (PN) during the transition from PN to enteral nutrition (EN) improves growth in preterm infants. New PN guidelines led to significantly better weight gain and z scores in the study group compared to controls.

Area of Science:

  • Neonatal nutrition
  • Pediatric growth and development
  • Intensive care medicine

Background:

  • Preterm infant growth is often compromised during nutritional transition.
  • Suboptimal nutrient intake during this phase is a likely cause.
  • New parenteral nutrition (PN) guidelines were implemented to address this.

Purpose of the Study:

  • To evaluate the impact of new PN guidelines on preterm infant growth.
  • To compare growth outcomes between infants receiving the new protocol and a control group.

Main Methods:

  • A chart review compared infants born <32 weeks gestation before and after protocol implementation.
  • Weight parameters and nutrient intakes during the transition phase were analyzed.
  • Growth z scores and weight gain were compared between control and study groups.

Main Results:

  • Study infants showed significantly higher weight-for-age z scores at the end of the transition phase and at 35 weeks gestation.
  • Average daily weight gain was higher in the study group (16.1 g/kg/d) vs. control (13.2 g/kg/d).
  • Improved growth was also observed in exclusively breastfed infants within the study group.

Conclusions:

  • Optimizing PN with concentrated solutions during the transition phase enhances nutrient intake.
  • This improved nutrition strategy leads to better growth rates in preterm infants.
  • The new PN guidelines effectively support improved growth outcomes.
Abstract

Keywords:
enteral nutritionlife cycleneonatesnutritionnutrition support practiceoutcomes research/qualityparenteral nutrition

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