Early enteral feeding in very low birth weight infants
| Autor: | Sarah N. Taylor, Emily Hamilton, Cynthia Massey, Julie Ross |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Male
Parenteral Nutrition Pediatrics medicine.medical_specialty Gestational Age Enteral administration Enteral Nutrition Enterocolitis Necrotizing Birth Weight Humans Infant Very Low Birth Weight Medicine EPOCH (chemotherapy) Retrospective Studies Milk Human business.industry Incidence (epidemiology) Infant Newborn Obstetrics and Gynecology Retrospective cohort study medicine.disease Low birth weight Breast Feeding Parenteral nutrition Pediatrics Perinatology and Child Health Necrotizing enterocolitis Cohort Premature Birth Female medicine.symptom business Infant Premature |
| Zdroj: | Early Human Development. 90:227-230 |
| ISSN: | 0378-3782 |
| Popis: | Debate exists about when to initiate enteral feeding (EF) in very low birth weight (VLBW) preterm infants. This retrospective study compared the effectiveness of an education-based quality improvement project and the relationship of time of the first EF to necrotizing enterocolitis (NEC) or death incidence and parenteral nutrition (PN) days in VLBW infants.VLBW infants born in 2 epochs were compared for hour of the first feed, PN days, NEC or death incidence, and feeding type. The 2 epochs were temporally divided by a quality improvement initiative to standardize initiation of EF in postnatal hours 6-24.603 VLBW infants were included. Median time of feed initiation decreased from 33 (Epoch 1) to 14h (Epoch 2) (p0.0001). Median PN days were 14 vs. 12, respectively (p=0.07). The incidence of NEC or death was 13.4% vs. 9.5%, respectively (p=0.14). When controlling for birth weight, gestational age, race, gender, and time period, earlier feed initiation was associated with decreased NEC or death (p=0.003). Evaluation of the relationship of early EF (defined as within the first 24h) in Epoch 2 alone showed that early EF was significantly associated with decreased NEC or death (6.3 vs 15.1%) (RR, 95% CI=0.28, 0.13-0.58) and less PN days (p0.0001).In a VLBW infant cohort, an education-based process improvement initiative decreased time of EF initiation to a median of 14h with no associated increase in NEC or death. In fact, results suggest that earlier feeding is associated with decreased NEC or death. |
| Databáze: | OpenAIRE |
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