Nutrition & Feeding

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

Do you monitor BUN to titrate protein intake during parenteral nutrition in VLBW infant's. If so, appreciate any good references supporting your rationale. Thank you.

Hello 99ers, In Canada, very few hospitals are using probiotics so far. We started almost 18 months ago, using the protocol from Dr. Keith Barrington's group. The product that we use is called "FloraBaby ®". At this point, the RNs receive a jar per baby, and on the benchtop where they do regular medication preparation, they place the jar on a paper towel, don sterile gloves, measure out the 0.5 g of powder, and mix it once daily with the baby's feed, then recap the jar & throw out the gloves and paper. That's it. Does anyone have a better idea on how to deal with live organisms? Do any countries who have been using probiotics for many years have a guideline…

We currently use a 2 in 1 TPN system in our NICU which is the practice recommended in all the references I have read. A different pharmacist has started coming into our unit (> 25yrs experience but in adult TPN) and is wanting to change to a 3 in 1 system to allow for 30% lipid emulsion to free up slightly more volume. I cited all the reasons for the 2 in 1 mixture that I am aware of: separate lipid has larger particle size and requires larger pore size filter of 1.2 microns, whereas a 0.22-micron (bacteria-eliminating) filter can be used for "main" bag when lipids are infused separately, and lipid makes it difficult to visualize precipitate or particulate material i…

Hai, can anyone help me to get freely downloadable TPN calculator