Nutrition & Feeding

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…

Regarding Marijuana. The American Academy of Pediatrics states that the use in breast milk from a mother using marijuana is contraindicated. The LacMed state that it is not contraindicated. The American College of OBGyN recommends that mothers stop using marijuana but does not mention stopping mothers from providing breast milk. There is a conflict between the benefits of breast milk in premies and the potential harm. What are your recommendations?

Hi Guys Is there anything called excessive weight gain in a premature (25+5 weeker) infant who is now 54 days old. Having gone through longterm MV, difficulties in getting extubated, use of steroids etc she is stable on CPAP currently and gaining weight 60-90 grams/day, at 180mls/kg/day of EBM and full strength fortifier. Her growth on chart going like mount everest...Bloods are normal...Creatinine is normal, urea is 8.9 which has crept up a bit. She is auto warning on her diuretics (0.8mg/kg) because of weight gain. Since she is gaining weight so fast, she appears oedematous to some nurses sometimes... but obviously she is not, its just fat as linear growth is yet …

Dear colleagues, We have now 34 weeks girl with mild RDS and right-sided congenital diaphragmatic hernia. Her vitals is stable, RDS is managed well by nasal CPAP. There is a liver in right thorax proven by CT. The Xray is below. My question is should we feed this baby enterally and how? Many thanks.

Hello to everybody, I wonder if in your NICU you add parenteral nutrition in the first days of life in premies >1,5 kg who are in good conditions and tolerate oral feeding to reach the high protein intake that s usually is considered. If I feed a premie with human milk in first days of life, I'm very far to obtain the proteic and caloric intake that are recommended, but it's very difficult for me (ethically) to find a central vein in a healthy premie (actually, I'll never reach the protein intake of parenteral nutrition feeding newborns with fortified human milk). Many thanks for your answers Marcello De Filippo II level NICU, Grosseto Italy

I would like to know if anyone is using the human milk analyser for macronutrient analysis of the preterm breast milk and accordingly fortification of the milk according to individual newborns needs . what has there experience been with the equipment by MIRIS ? Is it user friendly and requiring low maintenance ? What is the utility of this equipment in preterm care. Regards Dr Satyen K Hemrajani

In preemies, do you start calcium in the IV right away? How much? Do you have a problem with calcium infiltration of the skin? We have used D10 for the first day, then switch to D1/5. If they are still not tolerating feeds by the third day, we add KCl. When should we add calcium? Should we use D1/2 instead? Thanks