Nutrition & Feeding

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

Purpose of total parenteral nutrition is to prevent the adverse effect of malnutrition in neonate who are unable to obtain adequate nutrients by oral or enteral route (necrotising enterocolitis or nec, respiratory distress syndrom/bpd, extreme prematurity, sepsis and malabsorption. In our hospital we prepare the tpn according to each patient needs(calories,protein ,lipid,carbohydrate,multi-vitmns and electrolyts). As clinical pharmacist my part is to insure accuracy,stability and compatibilty as well as making sure all nutritions required are met. According to that before the physician start the tpn order he/she call me to discuse the patient nutrition requiremen…

Hello, i'd apreciate to know when do you use preterm formula at discharge in babies with no breast milk Do you use it either in late preterms and term sga newborns? When do you begin to use term formulas? At which weight? Thanks for your help Marcello De Filippo II level Neonatology Unit Grosseto, Italy

If a baby taken BL transfusion in nicu , when we start with him fe therapy

Is anyone implementing the Neo-BFHI in their units ? http://www.ilca.org/i4a/pages/index.cfm?pageid=4214 http://www.ilca.org/files/resources/NeoBFHI_Core_Document.pdf Nyqvist KH, Häggkvist AP, Hansen MN, Kylberg E, Frandsen AL, Maastrup R, Ezeonodo A, Hannula L, Koskinen K, Haiek LN. Expansion of the ten steps to successful breastfeeding into neonatal intensive care: expert group recommendations for three guiding principles. Journal of Human Lactation 2012;28(3):289-96 Nyqvist KH, Häggkvist AP, Hansen MN, Kylberg E, Frandsen AL, Maastrup R, Ezeonodo A, Hannula L, Haiek LN. Expansion of the Baby-Friendly Hospital Initiative ten steps to successful breastf…

Hi there, I recently have a discussion with my colleagues about the risks involved in managing neonates with below the liver UVC and running TPN through it. I could not find case reports that enlighten a better science. I would like to hear your opinion about this topic. What is your practice? 1. do you use low-line UVC to administer TPN? have you ever had any liver injury from TPN extravasation? if you use TPN in low-line UVC, is there any osmolarity you feel safe with? what about Ca in the TPN, do you use it regularly on low-line UVC? Thanks your your responses v/r Dr. Guerra

We were in the works to get the Solgar probiotic product used in the ProPrems trial (http://www.ncbi.nlm.nih.gov/pubmed/24249817) As far as we have understood - this is the product http://www.yourhealthfoodstore.co.uk/shop-by-department/supplements/pre-probiotics/pro/solgar-abc-dophilus-powder-children-and-infant-formula.html and we have been working to import it to Sweden. Now it seems that this specific product is recalled after a safety alert by the FDA http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm423277.htm Has anyone used this product and knows more about this recall? What is your strategy now, is there an…

I guess breastfeeding is a matter of debate outside Sweden too. I came across a very nice review on "Being baby friendly: evidence-based breastfeeding support". Naturally, the review is within the ADC paywall... but if you can't access it from your NICU - ask your hospital library to get it. http://fn.bmj.com/content/early/2014/10/07/archdischild-2013-304873.short?g=w_fn_ahead_tab

Parenteral nutrition is necessary for critically ill infants, and there are several ways to get solutions for parenteral nutrition. From mixing own solutions in the NICU to using commercially products "ready-to-use". What is your current practise regarding the TPN solutions. I will share the Karolinska way (which we currently discuss to revise...) in a separate post later.