Four-Week Nutritional Audit of Preterm Infants Born <33 Weeks Gestation
MetadataShow full item record
This is the accepted version of the following article: McLeod, Gemma and Sherriff, Jill and Nathan, Elizabeth and Hartmann, Peter and Simmer, Karen. 2013. Four-Week Nutritional Audit of Preterm Infants Born <33 Weeks Gestation. Journal of Paediatrics and Child Health. 49 (4): pp. E332-E339, which has been published in final form at <a href="http://doi.org/10.1111/jpc.12013">http://doi.org/10.1111/jpc.12013</a>
Aim: Preterm nutritional audits have previously been conducted using assumed milk composition. We audited protein and energy intakes in the first 28 days of preterm life using both assumed milk composition and milk analysis to assess their effect on weight gain and to determine if the recommended reasonable range of intakes were met. Methods: Parenteral and enteral intakes and weight gain were recorded daily for infants (n = 63) born <33 weeks gestation, using assumed milk composition. Macronutrient composition was determined by milk analysis for a subset of infants (n = 36). Linear mixed models analysis was used to assess the influence of energy and protein intakes on weight gain. Results: (Data median (range)): Infants (n = 63) gestation and birth weight were 30 (24–32) weeks and 1400 (540–2580) g, respectively. Macronutrient milk composition was variable: protein 16.6 (13.4–27.6) g/L, fat 46.1 (35.0–62.4) g/L, lactose 68.0 (50.9–74.8) g/L, energy 3074 (2631–3761) kJ/L. Intakes based on measured composition differed from assumed. Protein intake was significantly associated with weight gain. Compared to infants with longer gestations, those born <28 weeks gestation were fed lower volumes, were more reliant on parenteral nutrition, took an additional seven days to transition to fortified feeds and median weight gain velocity took a fortnight longer to reach targets.Conclusion: Preterm milk composition is variable and routine fortification using assumed composition may result in inappropriate nutrition. Fortification regimens stratified by birth gestation may be necessary to achieve preterm nutrition and growth targets. Milk analysis is required for accurate nutritional audit.
Showing items related by title, author, creator and subject.
Comparing different methods of human breast milk fortification using measured v. assumed macronutrient composition to target reference growth: a randomised controlled trialMcLeod, G.; Sherriff, Jill; Hartmann, P.; Nathan, E.; Geddes, D.; Simmer, K. (2015)The variable content of human breast milk suggests that its routine fortification may result in sub-optimal nutritional intakes and growth. In a pragmatic trial, we randomised infants born below 30 weeks of gestation to ...
Feasibility study: Assessing the influence of macronutrient intakes on preterm body composition, using air displacement plethysmographyMcleod, G.; Simmer, K.; Sherriff, Jill; Nathan, E.; Geddes, D.; Hartmann, P. (2015)Aim: Preterm nutrition guidelines target nutrient accretion and growth at intrauterine rates, yet at term equivalent age, the phenotype of the preterm infant differs from that of term infants. Monitoring early changes in ...
Feasibility of using ultrasound to measure preterm body composition and to assess macronutrient influences on tissue accretion ratesMcLeod, G.; Geddes, D.; Nathan, E.; Sherriff, Jillian; Simmer, K.; Hartmann, P. (2013)Background and aims: To assess ultrasound as a method for (i) measuring body composition (BC) of preterm infants and for (ii) assessing the influence of macronutrient intakes on tissue accretion rates. Methods: Preterm ...