Outcomes of Early Nutrition Support in Extremely Low‐Birth‐Weight Infants

Donovan, Ramona; Puppala, Bhagya L.; Angst, Denise B.; Coyle, Bryan W.

doi:10.1177/0115426506021004395

Cited by 49 publications

(33 citation statements)

References 20 publications

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“…Furthermore, the lack of association between earlier EN and reduced incidence of LOB in infants <28 weeks of gestation must be considered in view of other putative short-and long-term benefits that may be anticipated from early initiation of EN (intestinal trophic effects, impact on growth and long-term outcomes, etc.). 5,20 A recent meta-analysis, however, discerned no significant influence of early initiation of EN on weight gain, NEC, mortality or age at discharge. 15 Strengths of this study include its large sample size enabling adjustments for potential confounding variables.…”

Section: Discussionmentioning

confidence: 99%

Earlier initiation of enteral nutrition is associated with lower risk of late-onset bacteremia only in most mature very low birth weight infants

Lavoie

2009

J Perinatol

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Objective: To examine the temporal relationship between early enteral nutrition (EN) and coagulase-negative staphylococcal (CoNS)-related lateonset bacteremia (LOB) in very low birth weight (VLBW) neonates.Study Design: Multivariate analyses performed on a large retrospective cohort of neonates admitted to a tertiary care neonatal unit.Results: Due to the predominance and particular timing of CoNS, LOB occurred mostly during a critical period peaking at 9 days of age. This period also corresponded to a gestational maturation-dependent breakpoint in time to achieve full EN, associated with significant reduction in incidence of bacteremia (adjusted OR 0.15; 95%CI [0.10-0.20]; P<0.05). In subgroup analyses, more 'mature' (i.e. X28 and <32 weeks) preterm neonates reached full EN before this critical period and consequently, earlier EN in this group was associated with a shorter duration of PN and reduced incidence of CoNS bacteremia. In contrast, most 'immature' preterm neonates (i.e. <28 weeks) generally received PN beyond this critical period and therefore, did not appear to benefit from earlier initiation of EN. Even though EN was usually initiated earlier when formula milk was used as a complement to breast-milk, this practice was not associated with a reduction in the incidence of CoNS in any preterm gestational groups tested. Conclusion:A reduction in incidence of bacteremia was observed only in more mature VLBW neonates who achieved full EN before the secondweek of life critical period for CoNS, These results provide important endpoints for future trials evaluating changes in nutritional interventions potentially effective in reducing neonatal LOB.

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Section: Discussionmentioning

confidence: 99%

Earlier initiation of enteral nutrition is associated with lower risk of late-onset bacteremia only in most mature very low birth weight infants

Lavoie

2009

J Perinatol

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“…9 Initiation of early enteral feeds (minimal enteral nutrition), reaching adequate enteral intakes earlier, expanded use of human milk and reducing duration of total parenteral nutrition (TPN) are also beneficial. [10][11][12][13] Parenteral supplemental vitamin A to decrease BPD is used at many institutions. 14 Recently, calorically dense products, with an increased protein-to-energy ratio, have become available for fluid-restricted infants.…”

Section: Introductionmentioning

confidence: 99%

Nutritional strategies and growth in extremely low birth weight infants with bronchopulmonary dysplasia over the past 10 years

et al. 2011

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Objective: Changes in nutritional strategies over the past decade have been shown to improve postnatal growth in extremely low birth weight (ELBW) infants. We showed 10 years ago that the majority of these ELBW infants with bronchopulmonary dysplasia (BPD) suffer postnatal growth failure. We theorized that recent changes in nutritional support strategies would positively affect growth outcomes in ELBW infants with BPD.Study Design: A retrospective study of 88 ELBW infants with BPD. Nutritional data, postnatal growth and BPD severity were compared across three cohorts: (1) weight gain p14 g kg À1 per day, (2) 14.1 to 16 g kg À1 per day and (3) X16 g kg À1 per day from return to birth weight through discharge. We also compared these to a historical cohort.Result: In all, 73% of current subjects grew at or above fetal rates. There was less extrauterine growth restriction (EUGR) by weight and head circumference for those ELBW infants with BPD receiving higher amounts of protein. Aggressive early TPN and receipt of caloric-dense milk seemed to be the 'new' nutritional strategies improving growth for current ELBW infants with BPD compared with those 10 years ago.Conclusion: Despite a diagnosis of BPD, improved nutritional strategies have enhanced postnatal growth in infants at high risk for EUGR.

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“…Later Tatad and Frayer [3] in 2003 and Raja et al [4] in 2005 underpinned this statement by demonstrating improvement in survival rates for neonates due to advanced methods of neonatal care and nutrition, as well as in changes in the availability of neonatal care. Particularly the application of nutritional practices [5,6], and optimized early intervention programs for neonates of different birth weight and age groups [7] have shown to be quite effective. Within this framework a variety of methods like neonatal surfactant therapy [8], and adequate antibiotic therapy [9] are beyond dispute.…”

Section: Introductionmentioning

confidence: 99%

Systematic Review on Phytotherapy in Neonatology

Thiel

Längler²,

Ostermann³

2011

Forsch Komplementmed

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Background: There is an enormous economical significance of phytotherapy at least in Germany, the huge demand of patients was repeatedly proven. Simultaneously data exist for different application areas and ages as for younger children and pregnancy until birth. The actual neonatal period can be of interest because phytotherapy is used in younger children and until birth, it is not very likely that there is a gap in this period of life. Aim: To give an overview on the current literature on phytotherapy in neonatology. Methods: A systematic review was performed in the following databases: Cochrane, EM-BASE Alert, AMED, NCCAM, NLM, DIMDI, CAMbase, BIOSIS Previews, DAHTA, SciSearch, and Medline as well as in the archives of GMS, Karger, Kluwer, Thieme, Krause and Pachernegg, Wiley-Interscience/Phytotherapy Research, Springer and Merkurstab publishers. Keywords were neonatology, newborn, preterm, phytotherapy, phytomedicine, and herbal drugs in clinical randomized controlled studies. Results: We found 14 articles that fulfilled the inclusion criteria: 10 case control studies, 1 observational study, 1 study with interview, 1 with a questionnaire, and 1 retrospective study. Topics were aromatherapy, external applications, and internal effects of herbal teas. Conclusion: Indications, study design and explantory power of these publications were quite heterogeneous. Most promising was the study situation in aromatherapy. Due to the fact that phytotherapy is frequently used and there is a high demand of parents, methodologically excellent studies are needed to evaluate the significance of phytotherapy in the neonatal period. The aim is to fulfill scientific as well as economical needs. This review shows that there is no such evidence yet.

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Outcomes of Early Nutrition Support in Extremely Low‐Birth‐Weight Infants

Cited by 49 publications

References 20 publications

Earlier initiation of enteral nutrition is associated with lower risk of late-onset bacteremia only in most mature very low birth weight infants

Earlier initiation of enteral nutrition is associated with lower risk of late-onset bacteremia only in most mature very low birth weight infants

Nutritional strategies and growth in extremely low birth weight infants with bronchopulmonary dysplasia over the past 10 years

Systematic Review on Phytotherapy in Neonatology

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