Benefits of a Standardized Enteral Feeding Protocol on the Nutrition and Health Outcomes of Very Low Birth Weight Preterm Infants
Publication: Canadian Journal of Dietetic Practice and Research
3 May 2022
Abstract
Purpose: To compare nutrition and health outcomes before and after implementing a standardized enteral feeding protocol on nutrition and health outcomes in very low birth weight preterm infants.
Methods: A retrospective chart review was performed evaluating preterm infants, born less than 34 weeks gestation and weighing less than 1500 g, before and after the implementation of a standardized enteral feeding protocol. Outcomes included weaning of parenteral nutrition, initiation and advancement of enteral feeds, initiation of human-milk fortifier (HMF), change in weight z-score and neonatal morbidities.
Results: Fifty-six infants (30 in pre-group, 26 in post-group) met the inclusion criteria. Infants in the standardized enteral feeding protocol group started enteral feeds earlier (p = 0.039) and received full HMF fortification at lower weights (p = 0.033) than those in the pre-group. Fewer days on continuous positive airway pressure (p = 0.021) and lower rates of bronchopulmonary dysplasia (p = 0.018) were also observed in the post-group. Weaning of parenteral nutrition and weight z-score were not significantly different between groups. There were no differences in other morbidities.
Conclusion: Study results suggest that adopting a standardized enteral feeding protocol may promote early initiation of enteral feeds and fortification.
Résumé
Objectif. Comparer les résultats sur le plan de la nutrition et de la santé avant et après la mise en place d’un protocole normalisé d’alimentation entérale chez des enfants prématurés de très faible poids à la naissance.
Méthodes. Un examen rétrospectif des dossiers a été réalisé pour évaluer des enfants prématurés, nés à moins de 34 semaines de grossesse et pesant moins de 1 500 g à la naissance, avant et après la mise en place d’un protocole normalisé d’alimentation entérale. Les résultats comprenaient le sevrage de l’alimentation parentérale, l’introduction et la progression de l’alimentation entérale, l’introduction de fortifiant de lait maternel (FLM), l’évolution de l’écart réduit du poids et les morbidités néonatales.
Résultats. Cinquante-six nourrissons (30 à la phase pré-groupe, 26 à la phase post-groupe) répondaient aux critères d’inclusion. Les nourrissons du groupe du protocole normalisé d’alimentation entérale ont commencé l’alimentation entérale plus tôt (p = 0,039) et ont reçu une fortification par FLM complète à un poids plus faible (p = 0,033) que ceux du pré-groupe. Un nombre inférieur de jours de ventilation en pression positive continue (p = 0,021) et des taux inférieurs de dysplasie broncho-pulmonaire (p = 0,018) ont également été observés dans le post-groupe. Le sevrage de l’alimentation parentérale et l’écart réduit du poids n’étaient pas significativement différents entre les groupes. On n’a constaté aucune différence quant aux autres morbidités.
Conclusions. Les résultats de l’étude suggèrent que l’adoption d’un protocole normalisé d’alimentation entérale pourrait favoriser l’introduction précoce de l’alimentation entérale et de la fortification.
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Published In
Canadian Journal of Dietetic Practice and Research
Volume 83 • Number 3 • September 2022
Pages: 147 - 150
Editor: Naomi Cahill
History
Version of record online: 3 May 2022
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© 2022.
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RheaD’CostaMD, SandraFucilePhD, OT (reg), BrittanyDicksonRD, AlessiaGallipoliMD, and Kimberly EDowMD, FRCPC. 2022. Benefits of a Standardized Enteral Feeding Protocol on the Nutrition and Health Outcomes of Very Low Birth Weight Preterm Infants. Canadian Journal of Dietetic Practice and Research.
83(3): 147-150. https://doi.org/10.3148/cjdpr-2022-003
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