Background
Donor breast milk (DBM) feeding has been associated with less growth than formula in preterm infants. Zinc content in DBM is insufficient to support growth in preterm infants.
Objective
To compare growth from birth to discharge, macro- and micronutrient intake and the frequency of poor growth before (Epoch-1) and after (Epoch-2) implementing a DBM program.
Methods
Retrospective cohort study of 1069 infants born at < 33 weeks’ gestational age or birthweight < 1500 g and fed using our adjustable feeding protocol with accurate serial length measurements. Growth was assessed by changes in Z-scores of weight, length and fronto-occipital circumference from birth to discharge.
Results
Growth did not decrease significantly in Epoch-2. However, energy and protein intake increased by 5% and frequency of zinc and vitamin D supplementation increased by >30%.
Conclusions
DBM implementation did not significantly decrease growth from birth to discharge using our adjustable feeding protocol.
Objective: This study was designed to develop a multivariate prediction model using variables obtained at the time of sepsis evaluation to predict necrotizing enterocolitis (NEC) stage III or death within a week with an area under the curve (AUC)>0.90.
Study design: This is a retrospective cohort study (n=269) of preterm infants <33 weeks' gestation or <1500 grams birthweight either suspected or with NEC born at Parkland Health between 2009-2021. A multivariate prediction model using the new PACSOFAH score (Pneumoperitoneum, Abdominal Compartment Syndrome, Neonatal Sequential Organ failure Assessment (NSOFA) score, acidemia, hyperkalemia, hyperglycemia), gestational age and use of inotropes for hypotension during the prior week was compared with a similar model using NSOFA score.
Results: The PACSOFAH-model had a greater AUC than the NSOFA-model (0.92 vs 0.85, respectively, P=0.0005).
Conclusion: A new prediction model for death or NEC stage III was developed with AUC=0.92 at the time of initial sepsis evaluation.
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