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Abstract
Current nutritional recommendations for very low birthweight infants (VLBWI) focus on avoiding catabolism and supporting growth. We aimed to assess the results of a change in the parenteral nutrition protocol for VLBWI in our unit on the nutritional support received by these patients during the first week of life and the growth rates achieved.
Patients Infants < 1500g admitted to our unit one year before and one year after the change (periods I and II).
Method Revision of clinical charts and retrieval of data regarding nutritional intakes, growth and clinical outcomes.
Results 136 infants were studied (76 on period A and 60 on period B). There were no significant differences in baseline characteristics: gestational age (28.8±2.1 vs 29.0±2.0 weeks), birthweight (1.103±222 vs 1.091±214 g), gender distribution, perinatal characteristics and initial severity of illness. Parenteral nutrient supply was consistently higher throughout the first week in VLBWI in period II. There were no changes in enteral or total fluid supply.
The percentage of body weight loss was significantly lower in period B (11.3±4.9% vs 7.3±5.2%) and the recovery of birth weight was quicker (2 weeks vs 10 days, p<0,0001). The daily increase in weight was also significantly higher in the group with optimized nutrition, both from birth to day 14 of life and from day 14 to discharge.
Conclusions Extrauterine growth restriction is a prevalent complication of very preterm birth. Optimization of parenteral nutritional strategies in our neonatal unit had a positive effect in growth of this population during admission.