Changes in Parenteral Nutrition During the First Week of Life Influence Early but Not Late Postnatal Growth in Very Low-Birth-Weight Infants

Nutr Clin Pract. 2016 Oct;31(5):666-72. doi: 10.1177/0884533616649582. Epub 2016 May 17.

Abstract

Background and aims: Postnatal growth restriction remains a serious problem in very low-birth-weight infants. Enhanced parenteral supply of nutrients as soon as possible after birth is one of the strategies addressed to avoid extrauterine growth restriction. We aimed to analyze changes in growth patterns and in clinical outcomes in our unit after a change in our parenteral nutrition (PN) protocol.

Methods: We collected data from 2 time periods, comprising the 2 years before (period I) and the 2 years after (period II) the change of protocol. We included 142 very low-birth-weight infants ≤32 weeks of gestation with a birth weight ≤1500 g. Data regarding nutrition intakes (parenteral and enteral) in the first week of life, growth during admission, and clinical outcomes were retrieved from clinical charts.

Results: Babies in period II received a higher nutrition supply during the first week of life, but no further differences were found after this period. Weight at 14 days of life was significantly higher in period II but not at day 28 of life or discharge.

Conclusions: In our population, an enhanced PN regimen for very low-birth-weight infants led to a better growth at 14 days of life. However, this positive effect had disappeared at day 28 of life. Strategies to improve nutrient supply once the preterm baby is stable and on full enteral feeds should be implemented and analyzed.

Keywords: clinical protocols; enteral nutrition; outcomes assessment; parenteral nutrition; postnatal growth restriction; very low-birth-weight infant.

MeSH terms

  • Body Weight / drug effects*
  • Case-Control Studies
  • Child Development / drug effects*
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Very Low Birth Weight / growth & development*
  • Male
  • Nutritional Status*
  • Parenteral Nutrition / methods*
  • Parenteral Nutrition / statistics & numerical data
  • Retrospective Studies
  • Treatment Outcome