The Effect of Protein Intake on Composition of Weight Gain in Preterm Infants

1987 ◽  
pp. 143-149
Author(s):  
G. Putet ◽  
J. Rigo ◽  
B. Salle ◽  
J. Senterre
Keyword(s):  
Weight Gain ◽  
Preterm Infants ◽  
Protein Intake

scholarly journals Successfully implementing and embedding guidelines to improve the nutrition and growth of preterm infants in neonatal intensive care: a prospective interventional study

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e017727 ◽  
Author(s):  
Mark J Johnson ◽  
Alison A Leaf ◽  
Freya Pearson ◽  
Howard W Clark ◽  
Borislav D Dimitrov ◽  
...  
Keyword(s):  
Intensive Care ◽  
Weight Gain ◽  
Preterm Infants ◽  
Protein Intake ◽  
Neonatal Intensive Care ◽  
Control Period ◽  
Complex Interventions ◽  
Current Evidence ◽  
Interventional Study ◽  
Guideline Compliance

ObjectivesWe aimed to improve the nutritional care of preterm infants by developing a complex (multifaceted) intervention intended to translate current evidence into practice. We used the sociological framework of Normalization Process Theory (NPT), to guide implementation in order to embed the new practices into routine care.DesignA prospective interventional study with a before and after methodology.ParticipantsInfants <30 weeks gestation or <1500 g at birth.SettingTertiary neonatal intensive care unit.InterventionsThe intervention was introduced in phases: phase A (control period, January–August 2011); phase B (partial implementation; improved parenteral and enteral nutrition solutions, nutrition team, education, August–December 2011); phase C (full implementation; guidelines, screening tool, ‘nurse champions’, January–December 2012); phase D (postimplementation; January–June 2013). Bimonthly audits and staff NPT questionnaires were used to measure guideline compliance and ‘normalisation’, respectively. NPT Scores were used to guide implementation in real time. Data on nutrient intakes and growth were collected continuously.ResultsThere were 52, 36, 75 and 35 infants in phases A, B, C and D, respectively. Mean guideline compliance exceeded 75% throughout the intervention period, peaking at 85%. Guideline compliance and NPT scores both increased over time, (r=0.92 and 0.15, p<0.03 for both), with a significant linear association between the two (r=0.21, p<0.01). There were significant improvements in daily protein intake and weight gain between birth and discharge in phases B and Ccompared with phase A (p<0.01 for all), which were sustained into phase D.ConclusionsNPT and audit results suggest that the intervention was rapidly incorporated into practice, with high guideline compliance and accompanying improvements in protein intake and weight gain. NPT appears to offer an effective way of implementing new practices such that they lead to sustained changes in care. Complex interventions based on current evidence can improve both practice and clinical outcomes.

scholarly journals Digestive enzyme replacement relieves growth failure in preterm infants with poor exocrine pancreatic function: a retrospective case series

2021 ◽  
Author(s):  
Annette Münch ◽  
Christoph Bührer ◽  
Ann Carolin Longardt
Keyword(s):  
Weight Gain ◽  
Preterm Infants ◽  
Digestive Enzyme ◽  
Pancreatic Insufficiency ◽  
Growth Failure ◽  
Exocrine Pancreatic Function ◽  
Exocrine Pancreatic Insufficiency ◽  
Very Preterm Infants ◽  
Enzyme Replacement ◽  
Fecal Pancreatic Elastase

AbstractIn orally fed preterm infants, poor weight gain may be linked to low fecal pancreatic elastase-1 (FPE-1) activity, indicative of exocrine pancreatic insufficiency. The objective of this study was the retrospective assessment of the effect of exogenous digestive enzyme replacement by gavage in preterm infants with growth failure and low FPE-1 (<200 μg/g). We analyzed weight gain relative to baseline and caloric intake during 14-day periods before and after institution of digestive enzyme replacement containing 6000 U lipase and 240 U protease kg−1 d−1. Among 46 of 132 preterm infants < 1250g birth weight surviving to at least 14 days in whom FPE-1 was determined, 38 infants had low FPE-1 (< 200 μg/g), and 33 infants received exogenous digestive enzyme replacement. Average daily weight gain significantly increased from 14.4 [range 2.6–22.4] g kg−1 d−1 to 17.4 [8.4–29.0] g kg−1 d−1 (P = 0.001), as did weight gain per kcal, from 0.08 [0.02–0.13] g kcal−1 d−1 to 0.11 [0.05–0.18] g kcal−1 d−1.Conclusion: In preterm infants with signs and symptoms of exocrine pancreatic insufficiency, exogenous digestive enzyme replacement is associated with improved growth. What is Known:• Very preterm infants on full enteral nutrition may display growth failure linked to transient poor exocrine pancreatic function.• Porcine pancreatic enzymes covered with an acid-resistant coating are too large to pass the internal diameter of most gavage tubes used in very preterm infants.What is New:• Administration of a liquid formulation of acid-resistant microbial digestive enzymes in preterm infants with growth failure and low fecal pancreatic elastase-1 values was associated with improved weight gain.• Response to exogenous digestive enzyme replacement was associated with the prior extent of growth failure.

Gastric Lipolysis and Fat Absorption in Preterm Infants: Effect of Medium-Chain Triglyceride or Long-Chain Triglyceride-Containing Formulas

PEDIATRICS ◽  
1989 ◽  
Vol 83 (1) ◽  
pp. 86-92 ◽  
Author(s):  
Margit Hamosh ◽  
Joel Bitman ◽  
Teresa H. Liao ◽  
N. R. Mehta ◽  
R. J. Buczek ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Fatty Acid ◽  
Weight Gain ◽  
Preterm Infants ◽  
Lipase Activity ◽  
Medium Chain Triglyceride ◽  
Fat Absorption ◽  
Medium Chain ◽  
Long Chain ◽  
Long Chain Triglyceride

The extent of gastric lipolysis, fat absorption, and infant weight gain was studied in 12 preterm infants (gestational age 28.75 ± 0.50 weeks, postnatal age 6.08 ± 0.81 weeks) fed medium-chain triglyceride or long-chain triglyceride formula for 1 week in a crossover design. The former formula contained 42% of 8:0 and 10:0 and 19% of 12:0, 14:0, and 16:0; the latter formula contained only 7% of 8:0 and 10:0 and 46% of 12:0, 14:0, and 16:0. Gastric aspirates were obtained on the second and third day of formula feeding for quantitation of lipase activity and of the extent of gastric lipolysis. Fat balance studies were conducted during the last three days of each feeding regimen. The study showed that (1) there was marked hydrolysis of formula fat in the stomach during feeding of either medium-chain triglyceride formula or long-chain triglyceride formula (20% and 16%, respectively); (2) lipase activity in the gastric aspirates was less during feeding of medium-chain triglyceride formula than before the meal, which suggested stimulation of lipase secretion by long-chain fatty acid released from long-chain triglyceride formula fat or more rapid binding of lipase to ingested lipid in the medium-chain triglyceride formula; (3) fatty acid distribution in glycerides and free fatty acids showed preferential release of medium-chain (8:0, 10:0) and long-chain unsaturated (18:1, 18:2) fatty acids in the stomach. The low content of 8:0 and 10:0 in gastric triglyceride and free fatty acids suggested that medium-chain fatty acids were absorbed directly in the stomach. (4) fat balance studies showed almost identical absorption rates (84.6% ± 3.1% and 82.8% ± 4.0%) and weight gain (23.0 ± 1.5 g/d and 20.8 ± 1.8 g/d) during feeding of either medium-chain triglyceride or long-chain triglyceride formula. In this study, in which each infant was fed either formula alternately, it was shown that although the extent of fat digestion varied among infants, medium-chain and long-chain triglyceride were absorbed to the same extent by most infants.

Effect of Oral Motor Intervention on Oral Feeding in Preterm Infants: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-11
Author(s):  
Danna Chen ◽  
Zhen Yang ◽  
Chujie Chen ◽  
Pu Wang
Keyword(s):  
Weight Gain ◽  
Hospital Stay ◽  
Preterm Infants ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Oral Feeding ◽  
Transition Time ◽  
Cochrane Library ◽  
Oral Motor ◽  
Feeding Efficiency

Objective This review article aimed to explore the effect of oral motor intervention on oral feeding in preterm infants through a meta-analysis. Method Eligible studies were retrieved from four databases (PubMed, Embase, Cochrane Library, and Web of Science) up to July 2020 and screened based on established selection criteria. Thereafter, relevant data were extracted and heterogeneity tests were conducted to select appropriate effect models according to the chi-square test and I 2 statistics. Assessment of risk of bias was performed among the included studies. Finally, a meta-analysis was carried out to evaluate the effect of oral motor intervention in preterm infants according to four clinical indicators: transition time for oral feeding, length of hospital stay, feeding efficiency, and weight gain. Results Eighteen randomized controlled trials with 848 participants were selected to evaluate the effect of oral motor intervention on preterm infants. The meta-analysis results revealed that oral motor intervention could effectively reduce the transition time to full oral feeds and the length of hospital stay as well as increase feeding efficiency and weight gain. Conclusions Oral motor intervention was an effective way to improve oral feeding in preterm infants. It is worthy to be used widely in hospitals to improve the clinical outcomes of preterm infants and reduce the economic burdens of families and society. Future studies should seek to identify detailed intervention processes and intervention durations for clinical application.

scholarly journals EFFECTS OF SOURCE AND LEVEL OF NITROGEN ON THE UTILIZATION OF SORGHUM STOVER BY YANKASA RAMS

2021 ◽  
Vol 28 (2) ◽  
pp. 187-192
Author(s):  
F. OLALERU ◽  
T. A. ADEGBOLA
Keyword(s):  
Weight Gain ◽  
Protein Intake ◽  
Crude Protein ◽  
Live Weight ◽  
Ammonia Nitrogen ◽  
Feed Conversion ◽  
Acid Detergent Fibre ◽  
Designed Experiment ◽  
Digestible Crude Protein

The effects of cotton seed cake (CSC) or urea in supplying either 12% or 16% crude protein on sorghum stover utilization by Yankasa rams was studied for twelve weeks, using a 2 x 2 factorially designed experiment. Nutrient intake, digestibility, weight gain and feed conversion ratio (FCR) were monitored. In vitro volatile fatty acid (VFA) and ammonia-nitrogen (NH,-N) concentrations were also determined. The result of the study indicated that the source and/or level of nitrogen (or crude protein) significantly (P<0.05) affected crude protein intake (CPI), digestible crude protein intake (DCPI) and in vitro NH,-N concentration. Total feed intake, live weight gain (LWG), FCR and DCPI were significantly (P<0.05) affected by source x level interaction. Acid detergent fibre (A DF) and neutral detergent fibre (NDF) intakes, CP, ADF and NDF digestibilities, digestible ADF and NDF intakes, stover intake and in vitro VFA concentration were not significantly (P>0.05) affected by either main effects of CP source and level or their interaction. The rams on the 16% CSC and 12% urea ration gained more weight and had lower FCR than those on the 12% CSC and 16% urea. The 16% CSC ration gave the best result in terms of sorghum stover supplementation. The 12% urea treatment which also had a good result in terms of weight gain and FCR could also be recommended for use.

scholarly journals Nutritional Intake, White Matter Integrity, and Neurodevelopment in Extremely Preterm Born Infants

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3409
Author(s):  
Lisa M. Hortensius ◽  
Els Janson ◽  
Pauline E. van van Beek ◽  
Floris Groenendaal ◽  
Nathalie H. P. Claessens ◽  
...  
Keyword(s):  
White Matter ◽  
Preterm Infants ◽  
Motor Development ◽  
Protein Intake ◽  
Diffusion Tensor ◽  
Neurodevelopmental Outcome ◽  
White Matter Integrity ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Preterm Born

Background: Determining optimal nutritional regimens in extremely preterm infants remains challenging. This study aimed to evaluate the effect of a new nutritional regimen and individual macronutrient intake on white matter integrity and neurodevelopmental outcome. Methods: Two retrospective cohorts of extremely preterm infants (gestational age <28 weeks) were included. Cohort B (n = 79) received a new nutritional regimen, with more rapidly increased, higher protein intake compared to cohort A (n = 99). Individual protein, lipid, and caloric intakes were calculated for the first 28 postnatal days. Diffusion tensor imaging was performed at term-equivalent age, and cognitive and motor development were evaluated at 2 years corrected age (CA) (Bayley-III-NL) and 5.9 years chronological age (WPPSI-III-NL, MABC-2-NL). Results: Compared to cohort A, infants in cohort B had significantly higher protein intake (3.4 g/kg/day vs. 2.7 g/kg/day) and higher fractional anisotropy (FA) in several white matter tracts but lower motor scores at 2 years CA (mean (SD) 103 (12) vs. 109 (12)). Higher protein intake was associated with higher FA and lower motor scores at 2 years CA (B = −6.7, p = 0.001). However, motor scores at 2 years CA were still within the normal range and differences were not sustained at 5.9 years. There were no significant associations with lipid or caloric intake. Conclusion: In extremely preterm born infants, postnatal protein intake seems important for white matter development but does not necessarily improve long-term cognitive and motor development.

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