Adjustable feedings plus accurate serial length measurements decrease discharge weight-length disproportion in very...

Area of Science:

• Neonatal care
• Pediatric growth and development
• Nutritional science

Background:

• Preterm very-low-birth-weight infants often experience disproportionate weight-for-length growth during Neonatal Intensive Care Unit (NICU) stays.
• High rates of elevated Body Mass Index (BMI) at discharge and 1-year postnatal age are linked to adverse health outcomes later in life.

Purpose of the Study:

• To evaluate the impact of an adjustable feeding protocol utilizing serial length measurements on growth disproportion in preterm infants.
• To assess the long-term effects of this intervention on infant growth and Body Mass Index (BMI) at 1-year follow-up.

Main Methods:

• A quality improvement project was conducted in a single institution involving preterm infants (23 0/7 to 28 6/7 weeks gestational age).
• An adjustable feeding protocol was implemented, relying on accurate serial length measurements (using board or caliper) to guide nutritional adjustments.

Main Results:

• The incidence of weight-for-length disproportion at discharge significantly decreased from 13% to 0% after implementing the new protocol.
• While the average Z-score for BMI at discharge was lower post-intervention, this difference was not observed at the 1-year follow-up.

Conclusions:

• The combined approach of adjustable feedings and accurate length measurements effectively reduces weight-for-length disproportion at hospital discharge for preterm infants.
• The intervention's positive impact on growth disproportion does not extend to the 1-year postnatal age, suggesting ongoing growth challenges for this population.