Analysis of preterm infant feeding practices in a public maternity hospital of Rio de Janeiro, Brazil
Keywords:
Feeding, Risk groups, Infant, prematureAbstract
Objective
This study analyzed the early feeding practices and the type of diet at discharge of preterm infants.
Methods
This descriptive, retrospective two-year cohort study included 203 preterm infants (weight< 1.500g) from the Bonsucesso General Hospital, Rio de Janeiro. The following practices were analyzed: days to start enteral feeding, days to achieve full enteral feeding, days to start and duration of parenteral nutrition and also, type of diet at discharge.
Results
The mean time to start enteral feeding was 6.5 days (CI 95% 6.0-7.2); to achieve full enteral feeding, 18.9 days (CI 95% 17.6-20.3); to start parenteral nutrition, 2.8 days (CI 95% 2.6-3.0). Parenteral nutrition lasted 10.8 days (CI 95% 9.7-11.9). The feeding practices were associated and the highest correlation occurred between days to achieve full enteral feeding and duration of parenteral nutrition (Pearson=0.69). The length of time to start enteral feeding, achieve full enteral feeding and use of parenteral nutrition increases with decreasing birth weight. This trend was not observed for time to start parenteral nutrition. At discharge, the most common feeding practices were mixed feeding (61.6%) followed by formula feeding (26.1%) and exclusive breastfeeding (12.3%).
Conclusion
This study showed that there is a delay in starting to feed preterm infants. Total breastfeeding proportion at discharge was 74.0%. Efforts are necessary to start feeding these patients sooner and promote breastfeeding.
References
Barker DJ. The fetal and infant origins of adult disease. BMJ. 1990; 301(6761):1111.
Barker DJ. Fetal programming of coronary heart disease. Trends Endocrinol Metab. 2002; 13(9): 346-8.
Lucas A. Long-term programming effects of early nutrition-implications for the preterm infant. J Perinatol. 2005; 25(2):S2-6.
Mayhew SL, Gonzalez ER. Neonatal nutrition: a focus on parenteral nutrition and early enteral nutrition. Nutr Clin Pract. 2003; 18(5):406-13.
Evans RA, Thureen P. Early feeding strategies in preterm and critically ill neonates. Neonatal Netw. 2001; 20(7):7-18.
Ballard JL, Khoury JC, Wedig K, Wang L, Eilers- -Walsman BL, Lipp R. New Ballard Score, expanded to include extremely premature infants. J Pediatrics. 1991; 119(3):417-23.
Alexander GR, Himes MPH, Kaufman RB, Mor J, Kogan M. A United States National Reference for fetal Growth. Obstet Gynecol. 1996; 87(2):163-8.
International Neonatal Network. The CRIB (Clinical Risk Index for Babies) score: a tool for assessing initial neonatal risk and performance of neonatal intensive care units. Lancet. 1993; 342(8865): 193-8.
Bell MJ, Ternberg JL, Feigin RD. Neonatal necrotizing enterocolitis: therapeutic decisions based upon clinical staging. Ann Surg. 1978; 187(1):1-7.
Saadeh R, Benbouzid D. Breast-feeding and child- -spacing: importance of information collection for public health policy. Bull World Health Organ. 1990; 68(5):625-31.
Kuzma-O’Reilly B, Duenas ML, Greecher C, Kimberlin L, Mujsce D, Miller D, et al. Evaluation, development and implementation of potentially better practices in neonatal intensive care nutrition. Pediatrics. 2003; 111(4):e461-70.
Ahmed M, Irwin S, Tuthill DP. Education and evidence are needed to improve neonatal parenteral nutrition practice. JPEN. 2004; 28(3):176-9.
Slagle TA, Gross SJ. Effect of early low-volume enteral substrate on subsequent feeding tolerance in very low birth weight infants. J Pediatr. 1988; 113(3):526-31.
Tyson JE, Kennedy KA. Early trophic feeding for very low birth weight infants. Cochrane Database of Systematic Reviews. 2000; (2): CD000504. Cochrane Database Syst Rev. 2005; (3):CD000504. doi: 10.1002/14651858.
Anderson DM. Feeding the ill preterm infant. Neonatal Netw. 2002; 21(7):7-14.
Ehrenkranz RA, Younes N, Lemons JA, Fanaroff AA, Dovan EF, Wright LL, et al. Longitudinal growth of hospitalized very low birth weight infants. Pediatrics. 1999; 104(2):280-9.
Gregory JR, Campbell JR, Harrison MW, Campbell TJ. Neonatal necrotizing enterocolitis: a 10 year experience. Am J Surg. 1981; 141(5):562-7.
Williams AF. Role of feeding in the pathogenesis of necrotizing enterocolitis. Semin Neonatology. 1997; 2(4):263-71.
Callen J, Pinelli J. A review of the literature examinig the benefits and challenges, incidence and duration, and barriers to breastfeeding in preterm infants. Adv Neonatal Care. 2005; 5(2):71-88.
Spatz DL. Ten steps for promoting and protecting breastfeeding for vulnerable infants. J Perinat Neonatal Nurs. 2004; 18(4):385-96.
Were FN, Bwibo NO. Early growth of very low birth weight infants. East Afr Med J. 2006; 83(3): 84-9.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Cristina Ortiz VALETE, Rosely SICHIERI, Daniela Paes Leme PEYNEAU, Lívia Frankenfeld de MENDONÇA
This work is licensed under a Creative Commons Attribution 4.0 International License.
