Turkish Neonatal Society guideline on the parenteral nutrition in preterm infants

Abstract

Postnatal growth failure due to inappropriate and insufficient nutrition is a risk for preterm infants, especially for very-low-birth-weight or extremely-low-birth-weight infants. This extrauterine growth failure causes negative effects on long-term neurodevelopment. Early initiation of intensive parenteral nutrition with appropriate protein and energy supply is a nutritional emergency when enteral feeding cannot be achieved. This approach prevents protein catabolism and helps achievement of positive protein balance and postnatal growth. Protein, lipid, and glucose initiation with appropriate doses that reach timely goals constitute the major elements of parenteral nutrition. The transition to enteral nutrition with the mother’s milk at the earliest convenience must be targeted in parenteral nutrition.

Effect of Feeding Fresh or Frozen Breast Milk on the Gut Microbiota of Premature Infants: A Prospective Observational Study

“…The infant’s details were recorded on breast milk bags. Fresh breast milk brought to the unit was stored at 4°C for a maximum of 3 days (Bilgen et al, 2018), while frozen milk was stored in the deep freezer (−18°C). The infant was given fresh milk if the mother brought fresh breast milk.…”

Nutrition guidelines for preterm infants: A systematic review

“…The clarity of the presented recommendations (domain 4) was good (scored ≥60%) for all but one of the guidelines. 48,49 Editorial independence (domain 6) had the widest range of scores (0%-100%), with five guidelines scoring 0%. 28,33,38,40,41 Only four guidelines scored ≥60% for stakeholder involvement (domain 2) [26][27][28]46 and seven for rigor of development (domain 3).…”

“…25,52 Despite the very low certainty of evidence, one recommendation was strong. 25 Seven guidelines provided recommendations for parenteral energy intake 22,27,28,47,48,51,52 (Table S2). In most, the recommended parenteral energy intake started at 40-60 kcal.kg −1 .day −1 in the first 2 days, increasing to 60-120 kcal.kg −1 .day −1 at older ages, although two guidelines recommended a maximum of 100 kcal.kg −1 .day −1 .…”

“…Eight guidelines made a wide variety of recommendations about biochemical indicators for monitoring adequacy of enteral nutrition, including serum vitamin D, bone mineral status, full blood count, serum ferritin, blood urea nitrogen, serum prealbumin and albumin, sodium, potassium, phosphate, blood glucose, and bilirubin levels 25,29,30,33,38,44,48,52 (Table S16). None made recommendations about the frequency of monitoring.…”

“…There were 12 guidelines (44%) that reported the gaps in recommendations. 26,27,33,37,39,40,[42][43][44]46,48,49,52 Gaps that were recommendations based on a very low certainty of evidence were found in 10 guidelines (37%). [16][17][18][19][20][21][22][23]25,27,29,32,44,45,[47][48][49][50][51][52] We grouped the evidence gaps in the recommendations into 27 topics, of which eight were identified both by guidelines and very low certainty of evidence, 10 identified only by the guidelines, and nine identified only from a very low certainty of evidence (Table S17).…”