Korean J Pediatr.  2016 Apr;59(4):165-173. 10.3345/kjp.2016.59.4.165.

Modification of nutrition strategy for improvement of postnatal growth in very low birth weight infants

• Choi AY
• Lee YW
• Chang MY

• KMID: 2163108
• DOI: http://doi.org/10.3345/kjp.2016.59.4.165

Abstract

PURPOSE
To identify the effects of modified parenteral nutrition (PN) and enteral nutrition (EN) regimens on the growth of very low birth weight (VLBW) infants.
METHODS
The study included VLBW infants weighing <1,500 g, admitted to Chungnam National University Hospital between October 2010 and April 2014, who were alive at the time of discharge. Subjects were divided according to 3 periods: period 1 (n=37); prior to the PN and EN regimen being modified, period 2 (n=50); following the PN-only regimen modification, period 3 (n=37); following both PN and EN regimen modification. The modified PN regimen provided 3 g/kg/day of protein and 1 g/kg/day of lipid on the first day of life. The modified EN regimen provided 3.5-4.5 g/kg/day of protein and 150 kcal/kg/day of energy. We investigated growth rate, anthropometric measurements at 40 weeks postconceptional age (PCA) and the incidence of extrauterine growth restriction (EUGR) at 40 weeks PCA.
RESULTS
Across the 3 periods, clinical characteristics, including gestational age, anthropometric measurements at birth, multiple births, sex, Apgar score, surfactant use and PDA treatment, were similar. Growth rates for weight and height, from time of full enteral feeding to 40 weeks PCA, were higher in period 3. Anthropometric measurements at 40 weeks PCA were greatest in period 3. Incidence of weight, height and head circumference EUGR at 40 weeks PCA decreased in period 3.
CONCLUSION
Beginning PN earlier, with a greater supply of protein and energy during PN and EN, is advantageous for postnatal growth in VLBW infants.

Keyword

Parenteral nutrition; Enteral nutrition; Extrauterine growth restriction; Very low birth weight infant

MeSH Terms

Apgar Score
Chungcheongnam-do
Enteral Nutrition
Gestational Age
Head
Humans
Incidence
Infant*
Infant, Very Low Birth Weight*
Multiple Birth Offspring
Parenteral Nutrition
Parturition
Passive Cutaneous Anaphylaxis