Abstract
Objective:
To compare postnatal growth and nutritional deficits after the implementation of two different nutritional strategies in two consecutives periods of time.
Methods:
An early and aggressive nutritional regimen was used in a cohort of 117 very low birth weight (VLBW) infants. Amino acids were administered at the rate of 1.5 g/kg/day along with 5.6 mg/k/min of glucose flow on day 1 of life, and progressively increased to 4 g/kg/day and 13 mg/kg/min. Intravenous lipids were started at 0.5 g/kg/day at 24 h from birth, and increased to 3.5 g/kg/day; enteral feeding was begun at day 1 of life. Uni- and multivariate analyses were used to compare this group with the conventional group of 65 VLBW infants conservatively fed.
Results:
Univariate analysis showed that in the aggressive group there was a 66% reduction in the risk of post natal malnutrition at 40 weeks of postmenstrual age (OR 0.34; 95% CI 0.17–0.67). This difference persisted in the multivariate analysis. Energy and protein deficits were lower in the aggressive group (P<0.001).
Conclusions:
Early and aggressive introduction of total parenteral nutrition and enteral feeding resulted in better growth in weight, length and head circumference, and a reduction of nutritional deficits at 40 weeks of postmenstrual age.
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Acknowledgements
We thank Dr Ruben Alvaro, Professor of Pediatrics, University of Manitoba at Winnipeg, for help with manuscript and useful comments.
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Dinerstein, A., Nieto, R., Solana, C. et al. Early and aggressive nutritional strategy (parenteral and enteral) decreases postnatal growth failure in very low birth weight infants. J Perinatol 26, 436–442 (2006). https://doi.org/10.1038/sj.jp.7211539
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DOI: https://doi.org/10.1038/sj.jp.7211539
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