Very low birth weight infants can tolerate higher rates of infusion of intravenous fat emulsion solutions during the first week of life without significant adverse events.
Breast milk is the optimal source of nutrition for infants. According to research, neonates fed breast milk have a reduced risk of sepsis, increased feeding tolerance, a decreased incidence of necrotizing enterocolitis, and better neurodevelopmental outcomes. Unfortunately, researchers have not identified practices to reduce or eliminate the risk for errors in breast milk administration. This article discusses the potential hazards of incorrect administration of breast milk. It then describes how the tertiary care center at Children's Hospital of Illinois implemented a policy utilizing six sigma quality improvement methodologies to improve breast milk administration. Since implementation of this policy, the NICU at our hospital has reduced the risk of breast milk administration errors to less than 3.4 mistakes per million opportunities.
The objective of this study was to determine if there are any common “risk factors” that could assist clinicians in identifying premature infants who are at greater risk for developing necrotizing enterocolitis (NEC). This was a retrospective study of infants admitted to the neonatal intensive care unit at Children’s Hospital of Illinois, Peoria. In total, 384 charts were reviewed. Seventy-eight infants diagnosed with NEC were compared to 246 infants who did not have NEC. Maternal risk factors, infant demo-graphics, incidence of sepsis, H2 blockers prescribed, temperature, anemia, and day-of-life gut priming and enteral feedings were compared between the two groups for significant differences. Univariate tests and logistic regression demonstrated that mothers of infants who developed NEC had a higher incidence of premature rupture of membranes. Significantly more males developed NEC than females. African American infants had a higher incidence of developing NEC than white infants. Infants who developed NEC often had a prior diagnosis of sepsis and were prescribed H2 blockers more frequently. Infants who had early initiation of gut priming and earlier initiation of enteral feedings had significantly less incidence of NEC than infants whose gut priming and enteral feedings were delayed. This study supports that risk factors for NEC are multifactorial and could assist clinicians in identifying subgroups, within the neonatal population, that are at greater risk for this disease, leading to the implementation of strategies to reduce the onset of NEC. Unfortunately, the true etiology of NEC remains unclear.
The expected benefits of reinfusing succus entericus are to prevent atrophy of the distal gastrointestinal tract and to allow normal digestion and absorption of nutrients, electrolytes, minerals, and fluid."
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