Neoreviews
HOME HELP CONTACT US SUBSCRIPTIONS CME ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Take the CME quiz:
 Vol. 7 No. 12, December 2006
Right arrow E-Letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-Letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Adamkin, D. H.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Adamkin, D. H.

NeoReviews Vol.7 No.12 2006 e608
© 2006 American Academy of Pediatrics

Nutrition Management of the Very Low-birthweight Infant

II. Optimizing Enteral Nutrition and Postdischarge Nutrition

David H. Adamkin, MD*

* Professor of Pediatrics, University of Louisville, Louisville, Ky

The first 300 words of the full text of this article appear below.


   Objectives
 
After completing this article, readers should be able to:

  1. List the protein requirements for extremely low-birthweight neonates.
  2. Delineate the most desirable nutrition goal for the preterm infant.
  3. Describe the potential adverse effects of inadequate nutrient intakes in very low-birthweight infants.
  4. Explain the most appropriate diets and their benefits for preterm infants after hospital discharge.


   Introduction
 
Optimizing enteral nutrition (Fig. 1) begins as feedings are advancing and addresses the recommendation from the American Academy of Pediatrics Committee on Nutrition that preterm infants be provided levels of nutrients to permit growth and composition of weight gain for a normal fetus of the same postconceptional age. Normal concentrations of blood and tissue nutrients also must be maintained. However, many days or weeks may be required to achieve recommended intakes, particularly for infants who have major morbidities or are of extremely low birthweight (Fig. 2).


Figure Removed (Available Only in the Full Text)
View larger version (32K):



  		Figure 1. Aggressive nutrition to prevent extrauterine growth restriction. PWL=postnatal weight loss, RTBW=return to birthweight, TPN=total parenteral nutrition, D/C=discharge, IWL=insensible water loss, CAPS=baby hats, ICF=intracellular fluid, AA=amino acids, E/N=energy/nutrition, PTF=preterm formula, H.C.=head circumference. Reprinted with permission from Adamkin DH. J Perinatol. 2006;26(suppl 1):S27–S30.

 

Figure Removed (Available Only in the Full Text)
View larger version (52K):



  		Figure 2. Mean body weight versus gestational age in weeks for all study infants who had gestational ages at birth of between 24 and 29 weeks. Reprinted with permission from Ehrenkrantz RA, et al. Pediatrics. 2006;117:1253–1261.

 

   Determining Appropriate Intake
 
The most commonly used method for estimating the protein intake necessary to maintain the intrauterine rate of protein accretion is the factorial method, which includes an estimate of inevitable urinary nitrogen losses (ie, the losses that occur in the absence of nitrogen intake) and an estimate of the amount deposited in utero corrected for efficiency of absorption and deposition. An alternative method is to determine the actual intakes that support intrauterine rates of growth and nitrogen accretion. Interestingly, the two approaches do not . . . [Full Text of this Article]






HOME HELP CONTACT US SUBSCRIPTIONS CME ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2006 by the American Academy of Pediatrics.