There is increasing evidence that providing early and aggressive nutrition to premature infants improves clinical outcomes related to length of stay, weight gain and growth, and improved neurodevelopment. In addition, the early introduction of enteral feeding in premature infants prevents the adverse consequence of gut atrophy and promotes feeding tolerance. Despite the importance of nutrition to outcome, there is no consensus of how best to optimize practices. Feeding and nutrition practices often vary within units.
The purpose of the study was to determine if standardized feeding protocols and daily nutrition goals improved caloric intake, protein intake, and weight gain in the immediate perinatal period of infants weighing ≤ 1500 g at birth. In addition, the study examined the effect of a standardized feeding protocol on the initiation of enteral feeds and time to initiation of nipple feedings
The reducing complications team in neonatal intensive care established daily goals and instituted daily multidisciplinary rounds to enhance communication among team members. Nutrition bundles (protocols) were established with input from dietitians, the medical teams, pharmacy, nursing, and the hospital quality improvement staff. Daily fluid, caloric, and protein intake was discussed on rounds. In addition, daily and weekly weight gain and head circumference measurement were discussed.
During the first 6 months after initiation of the protocols, average protein intake on day 4 of life improved markedly (2.7‐3.9 g/kg a day; P = .0001). The average number of days from first enteral feed to enteral feeds at 100 kcal/kg a day decreased from 31.5 to 16.3 days (P= .0439). In addition, the number of days to full nipple feeds decreased from age 64.5 days to age 21.3 days (P ≤ .0001).
In conclusion, instituting daily multidisciplinary rounds and establishing daily goals improves nutrition in the immediate perinatal period. In addition, nutritional protocols and guidelines could potentially decrease the time to initiation and advancement of enteral feeds. We are currently examining the effects of these practices on somatic growth and length of hospital stay.
S. Sridhar, None.
To cite this abstract:Sridhar S. Quality Improvement to Optimize Neonatal Nutrition in Low‐Birth‐Weight Infants. Abstract published at Hospital Medicine 2007, May 23-25, Dallas, Texas Abstract 100. Journal of Hospital Medicine. 2007; 2 (suppl 2). https://www.shmabstracts.com/abstract/quality-improvement-to-optimize-neonatal-nutrition-in-lowbirthweight-infants/. Accessed April 10, 2020.