Nutrition & Feeding

Hi! I'd like to know what is your experience in enteral feeding advance in preterm with IUGR or centralization? It's well known that a faster incremention in enteral volumes provides faster achievement of full volume without worst outcomes (https://www.nejm.org/doi/full/10.1056/NEJMoa1816654). But, in preterm with IUGR it's very frequent feeding intolerance, even with MOM or DM. Do you use a diferent strategy? Thank you for your attention!

May I ask whether anyone has experience with a prolonged hanging time of a parenteral nutrition (PN) bag (incl lipids) of up to 48h? We are probably changing our PN regimen into an all-in-one bag. Since the bag contains >400 mL, it would suffice for most premature infants for 2 days. One strategy could thus be to prolong hang time from 24h to 48h to cut PN costs by half. A recent Australian study (attached) also suggests this would be a feasible approach: https://www.ncbi.nlm.nih.gov/pubmed/23320598 Since our pharmacy will do all additions to the bag in an aseptic environment, including connection and filling the line, I think it could be an attr…

Good morning to all. For many years, when a term or preterm neonate was admitted in a hemodynamically unstable state to the hospital where I did my fellowship, these neonates were generally managed with intravenous fluids that included dextrose, sodium, potassium and calcium exclusively before deciding to start the enteral route with MEF or administer TPN (this due to lack of the unit). My question is, in this case of hemodynamically unstable patients, and because they may present systemic arterial hypotension and variations in central glycemic levels, would the use of total parenteral nutrition be recommended? That is, how to deal with these variations in blood pressure.…

Hi everybody how are you Lately we are seeing an increase in neonatal Cholestasis associated to parenteral nutrition, they could help me with some strategy to prevent it. thank you the population are patients under 1000gs who for sepsis, nec, dap remain with npt for more than 10 days what strategy in the npt assembly with respect to lipid glucose proteins can prevent cholestasis, and even during cholestasis that npt could use

For babies, less than 1.5 kg, how often nurses in you NICU check for gastric residual? And if there is some gastric residual, then do nurses discard it OR push it back and give additional feeding? How you make decision to advance feeding based on amount of gastric residual, provided patient is otherwise doing well? Are these decisions based on evidence or personal preferences?

how can we estimate and subtract breastfeeding volume in a newborn taking intravenous fluid ?

I feel so curious about pre and probiotics in infants specially preterm...I have been reading in this topic for 2 years its known and applied in my home country Egypt...but not so common in country I work now KSA.. @Stefan Johansson 👋 wishing to know more 😊

Hi Friends, I am writing to you to ask for help in challenging a problem I have faced lately. In newborns with low birth weight minimal enteral feeding (MEF) should be introduced as soon as possible. Volume of MEF and it's components are not included in daily intake though. How to calculate the composition of food if enteral feeding will exceed MEF? Should the components given with parenteral and enteral nutrition be sumed up or should the part of food corresponing to MEF be removed? These information will help me to improve the spreadsheet describing composition of parenteral nutrition taking into account the enteral feeding. Best Regards Krzysztof Stempniewicz MD N…

I am on a committee for enteral feeds for ELBW infants. I've pulled some recent literature to see what I could find and there are conflicting viewpoints on whether feeds should advance more slowly or faster in ELBW infants. What is your guideline for enteral feeds progression in the ELBW infant? Kärsten

I'm working on a practice change for our unit with regard to the human milk spills that are a normal part of pumping for and feeding infants. The obvious solution is to wipe them with paper towels and then sanitize the area, but what do you do when the spot is dried before you see it? Our mothers pump at bedside, and we are often faced with dried spots of milk on the plastic chairs and bedside shelves after mothers have left. Our sanitizers: Sani-Cloth and Oxycide, do not lift the milkfat, and one of them even crystalizes it, making removal extremely difficult.My questions are as follows: 1. What does your infection control say about spilled milk? 2. What solut…