Nutrition & Feeding

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…

Apart from the fact that preterm babies less than 35 weeks were not included in the sugar babies study and also possibly may have swallowing issues, is there any other reason why glucose gel is not being used for preterm infants less than 35 weeks and is anyone of you recommending the use in preterm infants less than 35 weeks and upto what gestational age in case you are using?.

An interesting article just came on my radar, an international survey study on diagnosis and management of ankyloglossia (tongue-tie). The paper is Open Access in the October issue of @Acta Paediatrica, here: https://onlinelibrary.wiley.com/doi/10.1111/apa.14242 The conclusion reads On topic: here is a great article on Don't Forget The Bubbles (great web resource for ped fellows): https://dontforgetthebubbles.com/tongue-tie-cut/ Where I work, we are commonly consulted by midwifes about tongue.ties, and without knowing an actual rate, I'd say that we do relatively many frenectomies. We give sugar orally as analgesia and then one scissor "snip". W…