Nutrition and Growth Analysis of Very Low Birth Weight Infants

PEDIATRICS ◽  
1990 ◽  
Vol 86 (3) ◽  
pp. 378-383
Author(s):  
Tanis R. Fenton ◽  
Douglas D. McMillan ◽  
Reg S. Sauve

The growth and nutrition of 220 very low birth weight infants were reviewed after comprehensive data on all infants in the hospital were entered into the Neonatal Intensive Care Unit Audit Data Base for 2 years prospectively. Fluid and energy (parenteral and oral) intakes were compared in four birth weight categories (1, ı750 g; 2, 751 to 1000 g; 3, l001 to 1250 g; 4, 1251 to 1500 g). Parenteral nutrition was the major source of first nutrition for the small infants, but seldom did it alone provide adequate nutrition for very low birth weight infants. The age of the first nutrition (parenteral and/or oral nutrition other than dextrose) decreased with increasing birth weight. The age of the first oral feedings was later for the infants of the lower birth weights but enteral feeding became the major nutrition for all weight categories by the second week of life. During the first 50 days the infants accumulated a deficit of 3780 to 5460 kJ relative to their estimated need of 504 kJ/kg per day, with the smaller infants accumulating a significantly larger deficit. The growth of infants appropriate for gestational age and of infants small for gestational age differed from each other and from the commonly used graph of Dancis et al (J Pediatr. 1948;33:570-572).

2021 ◽  
Author(s):  
Teodoro Durá-Travé ◽  
Isabel San Martín-García ◽  
Fidel Gallinas-Victoriano ◽  
María Malumbres-Chacón ◽  
Paula Moreno-González ◽  
...  

Features of catch-up growth are not well established in very low birth weight infants (VLBW). The aim of this study is to analyze the catch-up growth in height and some factors associated in a cohort of VLBW (<1500 g) from birth to age 14 years. Retrospective registration of weight and height at birth and ages 0.5, 1, 2, 3, 4, 6, 8, 10, 12 and 14 years in a cohort of 170 VLBW have been recorded Anthropometric variables were compared with those from a control group. Sixty-nine (40.6%) were small for gestational age (SGA subgroup) and 101 (59.4%) were appropriate for gestational age (AGA subgroup). Thirty-seven (21.8%) were extremely low birth weight (ELBW), and 32 (18.8%) extremely preterm (EPT). At age 2, 4 and 10 years, 49.4%, 78.9% and 87.1% VLBW, respectively, did reach normal height. Between 4 and 10 years of age, only 8.2% of VLBW reached normal height. At 10 years of age, 7% of VLBW (1000–1500 g) and 35% of ELBW (<1500 g) showed short stature (p = 0.001). Almost the entire sample of VLBW with normal height at age 2, 4 and 10 have reached an adequate catch-up growth in weight in the previous evaluations. ELBW, SGA and EPT were found to be independent predictors for inadequate catch-up growth in height at 2, 4, and 10 years of age. The growth pattern of children born preterm has particular features: they have a lower rate and/or slowness in the catch-up growth in height with respect to that described in full-term small-for-gestational-age infants. Catch-up in weight appears to be a decisive factor for catch-up in height, and, on this basis, we recommend a rigorous nutritional follow-up in these individuals. If these measures do not help improve catch-up in height, they may be eligible for the establishment of rhGH therapy.


2020 ◽  
pp. 089033442098192
Author(s):  
Mariana González de Oliveira ◽  
Desirée de Freitas Valle Volkmer

Background The mothers of very low birth weight infants face many challenges to achieve breastfeeding at hospital discharge, especially during long stays. Research aim The aim of this study was to describe the incidence and factors associated with breastfeeding rates (exclusive or with formula) at discharge, for very low birth weight infants, in a private Neonatal Intensive Care Unit in southern Brazil. Methods We conducted a prospective longitudinal cohort study of infants ( N = 335) with very low birth weight and/or less than 30 weeks gestational age, who survived to discharge and had no contraindication to mother’s own milk. Participants were initially divided into three groups (exclusive breastfeeding, some breastfeeding, and no breastfeeding) based on their feedings at discharge; however, later, two groups were analyzed (any breastfeeding, no breastfeeding). Results Most (93.4%; n = 313) were breastfeeding directly at least once daily at discharge, of which 16.1% ( n = 54) were receiving exclusive mother’s milk and 77.3% ( n = 259) mixed feeding (mother’s milk and formula). Breastfeeding at discharge was associated with gestational age ≥ 28 weeks, higher birth weight, not developing neonatal sepsis or bronchopulmonary dysplasia during the hospital stay, shorter lengths of stay, and lower weight at discharge. After Poisson regression, breastfeeding at discharge was associated only with a shorter length of stay (RR 0.98; CI 95% [0.95, 0.99], p < .05). Conclusions In our single unit experience in Brazil, most infants were breastfeeding at discharge. NICU staff might address mothers of infants who have prolonged hospitalization with specific strategies. Mothers and infants at risk can be identified early and personalized interventions can be developed for improving breastfeeding rates at discharge.


PEDIATRICS ◽  
1993 ◽  
Vol 91 (5) ◽  
pp. 922-926
Author(s):  
Kelly Wright ◽  
Joan P. Dawson ◽  
Donna Fallis ◽  
Elanita Vogt ◽  
Vichien Lorch

Objective. To generate contemporary postnatal growth curves for hospitalized very low birth weight infants. Design. Retrospective survey. Setting. Tertiary intensive care nursery. Patients. All surviving singleton, appropriate-for-gestational age infants with birth weight ≤1500 g, born January 1, 1987, to May 31, 1991, who did not develop necrotizing enterocolitis (N = 205). Measurements and results. Macronutrient intakes and body weights were recorded daily, with crown-heel length and occipital-frontal head circumference recorded weekly up to 105 days of age or hospital discharge, whichever occurred first. Growth curves were generated for four birth weight ranges: 501 through 750, 751 through 1000, 1001 through 1250, and 1251 through 1500 g. Compared to previously published growth curves, the current infants regained birth weight more quickly and exhibited larger average daily weight gains. These differences were most apparent in infants of lowest birth weight. Conclusions. The "premature growth grid" constructed by Dancis et al more than 40 years ago may no longer be a useful standard of early postnatal growth for present-day very low birth weight, appropriate-for-gestational-age infants. The new weight curves are a more accurate reflection of current in-hospital growth trends, especially for infants weighing ≤1000 g at birth.


2016 ◽  
Vol 61 (1) ◽  
pp. 90-95 ◽  
Author(s):  
Jadwiga Wójkowska-Mach ◽  
T. Allen Merritt ◽  
Maria Borszewska-Kornacka ◽  
Joanna Domańska ◽  
Ewa Gulczyńska ◽  
...  

PEDIATRICS ◽  
1992 ◽  
Vol 89 (2) ◽  
pp. 357-357
Author(s):  
HELEN HARRISON

To the Editor.— The authors of the National Institute of Child Health and Human Development report on neonatal care1 found "important" variations among neonatal intensive care units in philosophies of treatment, methods of treatment, and short-term outcomes. In a recent meta-analysis of follow-up studies,2 researchers document a similarly haphazard approach to the long-term evaluation of very low birth weight survivors. Until randomized controlled clinical trials validate the safety and efficacy of neonatal therapies, and until long-term outcomes are assessed accurately, the treatment of very low birth weight infants should be declared experimental.


2020 ◽  
Vol 63 (8) ◽  
pp. 284-290 ◽  
Author(s):  
Jang Hoon Lee ◽  
YoungAh Youn ◽  
Yun Sil Chang ◽  

Korea currently has the world’s lowest birth rate but a rapidly inreasing number of preterm infants. The Korean Neonatal Network (KNN), launched by the Korean Society of Neonatology under the support of Korea Centers for Disease Control, has collected population-based data for very low birth weight infants (VLBWIs) born in Korea since 2013. In terms of the short-term outcomes of VLBWIs born from 2013 to 2016 registered in the KNN, the survival rate of all VLBWIs was 86%. Respiratory distress syndrome and bronchopulmonary dysplasia were observed in 78% and 30% of all VLBWIs, respectively. Necrotizing enterocolitis occurred in 7%, while 8% of the VLBWIs needed therapy for retinopathy of prematurity in the neonatal intensive care unit (NICU). Sepsis occurred in 21% during their NICU stay. Intraventricular hemorrhage (grade ≥III) was diagnosed in 10%. In terms of the long-term outcomes for VLBWIs born from 2013 to 2014 registered in the KNN, the post-discharge mortality rate was approximately 1.2%–1.5%, mainly owing to their underlying illness. Nearly half of the VLBWIs were readmitted to the hospital at least once in their first 1–2 years of life, mostly as a result of respiratory diseases. The overall prevalence of cerebral palsy was 6.2%–6.6% in Korea. Bilateral blindness was reported in 0.2%–0.3% of VLBWIs, while bilateral hearing loss was found in 0.8%–1.9%. Since its establishment, the KNN has published annual reports and papers that facilitate the improvement of VLBWI outcome and the formulation of essential healthcare policies in Korea.


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