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Validation of Test Weighing Protocol to Estimate Enteral Feeding Volumes in Preterm Infants
Michael W Rankin1, Elizabeth Yakes Jimenez2, Marina Caraco1
1Department of Pediatrics, Division of Neonatology, University of New Mexico School of Medicine, Albuquerque, NM.
Insights
Accurate enteral feeding volumes in preterm infants can be estimated using pre- and postfeeding weights. This test weighing method supports breastfeeding in the neonatal intensive care unit.
Area of Science:
- Neonatalogy
- Pediatric Nutrition
- Clinical Measurement
Background:
- Accurate estimation of enteral feeding volumes is crucial for preterm infants.
- Current methods may have limitations in precision and practicality.
Purpose of the Study:
- To evaluate the accuracy of pre- and postfeeding weights for estimating enteral feeding volumes in preterm infants.
Main Methods:
- A single-center prospective cohort study involving infants aged 28-36 weeks corrected age.
- Multiple pre- and postgavage feeding weights were obtained by blinded personnel following a specific protocol.
- Statistical analyses, including correlation and graphical methods, assessed the relationship between weight difference and ingested volume.
Main Results:
- Estimated and actual feeding volumes showed a high correlation (r=0.94, P<.001).
- The mean absolute difference between estimated and actual volumes was 2.95 mL, with 85% of measurements within ±5 mL.
- Protocol adherence significantly improved accuracy, with 89% of weights within ±5 mL compared to 71% when protocol adherence was compromised.
Conclusions:
- Pre- and postfeeding weights, when measured using a standard protocol, accurately estimate enteral feeding volumes in preterm infants.
- Test weighing is a valuable tool that can support direct breastfeeding initiatives within the neonatal intensive care unit.
Objective:
To evaluate the accuracy of pre- and postfeeding weights to estimate enteral feeding volumes in preterm infants.
Study Design:
Single-center prospective cohort study of infants 28-36 weeks' corrected age receiving gavage feedings. For each test weight, 3 pre- and 3 postgavage feeding weights were obtained by study personnel, blinded to feeding volume, via a specific protocol. The correlation between test weight difference and actual volume ingested was assessed by the use of summary statistics, Spearman rho, and graphical analyses. The relationship between categorical predictive variables and a predefined acceptable difference (±5 mL) was assessed with the χ2 or Fisher exact test.
Results:
A total of 101 test weights were performed in 68 infants. Estimated and actual feeding volumes were highly correlated (r = 0.94, P < .001), with a mean absolute difference of 2.95 mL (SD: 2.70; range: 0, 12.3 mL; 5th, 95th percentile: 0, 9.3); 85% of test weights were within ±5 mL of actual feeding volume and did not vary significantly by corrected age, feeding tube or respiratory support type, feeding duration or volume, formula vs breast milk, or caloric density. With adherence to study protocol, 89% of test weights (66/74) were within ±5 mL of actual volume, compared with 71% (19/27, P = .04) when concerns about protocol adherence were noted (eg, difficulty securing oxygen tubing).
Conclusions:
Via the use of a standard protocol, feeding volumes can be estimated accurately by pre- and postfeeding weights. Test weighing could be a valuable tool to support direct breastfeeding in the neonatal intensive care unit.
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