Nutritional practices in very low birth weight infants: a national survey

Area of Science:

• Neonatal Nutrition
• Pediatric Gastroenterology
• Clinical Practice Surveys

Background:

• Improving nutritional support for very preterm infants is a key focus in neonatal care.
• Large-scale surveys are crucial for understanding current nutritional practices in neonatal units.
• Assessing adherence to established guidelines for preterm infant nutrition is essential.

Purpose of the Study:

• To investigate the current clinical feeding practices for very low birth weight (VLBW) infants in tertiary neonatal hospitals.
• To evaluate the alignment of these practices with existing nutritional guidelines.
• To identify variations in nutritional support strategies across different neonatal units.

Main Methods:

• A multicentre, nationwide, web-based survey was conducted.
• The survey targeted tertiary neonatal hospitals admitting infants with birth weight < 1,500 g or gestational age < 32 weeks.
• Data were collected from 53 units, achieving a 59% response rate.

Main Results:

• Over 90% of units initiate amino-acid administration immediately after birth; more than half utilize fish oil-based lipid emulsions.
• Enteral nutrition begins within 24 hours in 65% of units, with feeding volumes increased by 10-30 ml/kg/day in over 90%.
• Human milk fortification and iron supplementation are nearly universal, but vitamin D administration (800 IU/day) is low (30%), and 50% of units use preterm formula at discharge.

Conclusions:

• Spanish neonatology units commonly employ early amino-acid and novel fish oil-based lipid emulsions for VLBW infants.
• Significant variability exists in post-discharge nutrition strategies and vitamin D supplementation.
• Further standardization of nutritional protocols, particularly for vitamin D and discharge feeding, is warranted.