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Growth of Infants with Intestinal Failure or Feeding Intolerance Does Not Follow Standard Growth Curves
Danielle L Morton1, Keli M Hawthorne2, Carolyn E Moore3
1SNG Dialysis, 1520 W. Frank St., Lufkin, TX 75904, USA.
Insights
Infants with intestinal failure or feeding intolerance experience impaired growth velocities and declining growth percentiles. Their development deviates significantly from standard growth curves during the first three months of life.
Area of Science:
- Neonatalogy
- Pediatric Gastroenterology
- Growth and Development
Background:
- Infants with intestinal failure or feeding intolerance are at high risk for extrauterine growth restriction.
- Nutritional compromise significantly impacts infant development and long-term health outcomes.
Purpose of the Study:
- To evaluate the growth velocities of infants with intestinal failure and feeding intolerance during the first three months of life.
- To determine the growth percentiles at birth and 40-week postmenstrual age (PMA) in this vulnerable population.
Main Methods:
- A retrospective chart review of 164 infants managed by the Texas Children's Hospital Intestinal Rehabilitation Team (April 2012 - October 2014).
- Calculation of weekly weight, length, and head circumference growth velocities.
- Comparison of growth data against Olsen growth curves to establish precise percentiles.
Main Results:
- Average growth velocities for weight gain (19.97 g/d), length (0.81 cm/week), and head circumference (0.52 cm/week) at 3 months were below expected norms.
- Growth velocities further decreased by discharge or death, except for weight gain (20.56 g/d).
- Significant decreases in weight, length, and head circumference percentiles were observed from birth to 40-week PMA (P < 0.001).
Conclusions:
- Infants with intestinal failure or feeding intolerance exhibit growth patterns that do not align with standard growth curves.
- These findings highlight the critical need for specialized monitoring and interventions to support growth in this population.
Abstract:
Objective. Infants with intestinal failure or feeding intolerance are nutritionally compromised and are at risk for extrauterine growth restriction. The aim of the study was to evaluate growth velocities of infants with intestinal failure and feeding intolerance for the first three months of age and to determine growth percentiles at birth and at 40-week postmenstrual age (PMA). Methods. A chart review of infants followed by the Texas Children's Hospital Intestinal Rehabilitation Team was conducted from April 2012 to October 2014. Weekly weight, length, and head circumference growth velocities were calculated. Growth data were compared to Olsen growth curves to determine exact percentiles. Results. Data from infants (n = 164) revealed that average growth velocities of 3-month-old infants (weight gain, 19.97 g/d; length, 0.81 cm/week; head circumference, 0.52 cm/week) fluctuated and all were below expected norms. At discharge or death, average growth velocities had further decreased (length, 0.69 cm/week; head circumference, 0.45 cm/week) except for weight, which showed a slight increase (weight, 20.56 g/d). Weight, length, and head circumference percentiles significantly decreased from birth to 40-week PMA (P < 0.001). Conclusions. Growth of infants with intestinal failure or feeding intolerance did not follow standard growth curves.