Nutrition & Feeding

Namaste What are your policies regarding feeding of the preterm of newborns specifically pertaining the following questions. When to start feeds (LBW/VLBW/ELBW) ? What should be the initial volume of feeds and volume of increment ? What to feed (EBM/Donor milk/Preterm formula) ? When to add HMF ? How long do you store the milk after adding HMF ? Where do you store it? How do you define feed intolerance and how do you tackle it ? Any other information on feeding of the preterm newborn Would be obliged if you could provide references ? You can send me an answer to my directly on kpsanghvi@hotmail.com

Hi friends We are trying to change from a conservative to more aggressive feeding protocol based on current evidence on its safety. We will be using breast milk exclusively. I have seen the previous post on this topic but looking for a formal protocol/algorithm on feeding and dealing with gastric residuals. Appreciate your help! Mike sukumar MD Neonatologist Rockville MD USA

Hi - our NICU team has been trying to be more consistent with how we transition babies from tube to oral feeds, parents have shared their frustration with differences amongst team members. We have developed a protocol and supporting resources. Here is the link to our project resources: http://sofi.nicu.ca/, ..regards Victoria General Hospital NICU team.

preterm baby his BW is 1000g, enter nicu for gaining wt firstly brown aspirate with trophic feeding then start greenish aspirate and dealed as NEC , so NPO for 1 w without stopping of greenish aspirate reach till 15 ml/day, so gastrograffin study was done and revealed free study and baby pass motion in spite green aspirate so i start with him erythromycin as pro-kinetic drug for 1 w and stop and start feeding again very slowly and now he tolerate 3cc/kg every 3h with no residual now what is your opinion in this case , what is possible diagnosis????

This is regarding the Fonterra recall of its batch of ?Botulism tainted products. - http://online.wsj.com/article/SB10001424127887323681904578646952552857298.html --- http://www.aljazeera.com/news/asia-pacific/2013/08/201383044280669.html -- http://www.stuff.co.nz/business/farming/dairy/9004324/Fonterra-products-whipped-off-Chinese-shelves Has it affected you ? It seems to have already affected Saudi Arabia - http://www.arabnews.com/news/460297 Could members post in this thread if they become aware of new developments in this story

I'd like to know if anyone use omega3 (fish oil OMEGAVEN) in total parenteral nutrition in case of very immature newborns at risk of Parenteral nutrition-Associated Cholestasis. Thanks

How frequent is the incidence of cholestatic jaundice associated with TPN? In my own experience almost all babies, whom we had started on TPN, developed cholestatic jaundice.

Interesting Study Katz Y, Rajuan N, Goldberg MR, Eisenberg E, Heyman E, Cohen A, Leshno M. Early exposure to cow's milk protein is protective against IgE-mediated cow's milk protein allergy. J Allergy Clin Immunol. 2010 Jul;126(1):77-82.e1. Epub 2010 Jun 11. PubMed PMID: 20541249. LINK

We use a barcode system to scan breastmilk to verifiy that it belongs to correct mother and baby. What do other NICU's do? Do you use barcode systems, double check with another person before feeding, or do you verify at all?

Kindly advise me what is the ideal material to be used for containers in which expressed breast milk can be stored in refrigerators.I am aware that glass is ideal but it is practically difficult. I am using stainless steel containers as of now.Is plastic any way superior to it.Kindly also suggest me the references. The reason for the question is problems of rusting with stainless steel material