Evidence-based feeding guidelines for very low-birth-weight infants.
Clinical practice guidelines (CPG) for the nutritional management of premature infants are limited. This project focused on the development of a research-based enteral feeding CPG for infants of < 1,500 g. The CPG was based on an extensive literature review and developed through a process of consensus decision making by a team of clinical researchers. Infants that weigh < 1,000 g initiate minimal enteral nutrition (MEN) at 48 hours; nutritional feedings begin on day 5 to 6 of life. For infants between 1,000 and 1,500 g, nutritional feedings begin at 48 hours and are advanced at a rate of less than 30 mL/kg per day. The benefits and risks of continuous versus intermittent nasogastric tube feeding were inconclusive; therefore, the CPG does not stipulate a feeding method. Breast milk is used preferentially, and specific guidelines for the definition and management of feeding intolerance are provided. A follow-up study testing this CPG has been completed and is published in the original research section of this issue.
Premji
Shahirose S
SS
Department of Pediatrics/Faculty of Nursing, University of Calgary, Calgary Health Region, Foothills Medical Centre, Calgary, Alberta, Canada. premjis@ucalgary.ca
Paes
Bosco
B
Jacobson
Kevan
K
Chessell
Lorraine
L
D032921:Consensus; D019317:Evidence-Based Medicine; D005248:Feeding Methods / Q000451:nursing; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D015931:Intensive Care, Neonatal / Q000592:standards*; D017283:Neonatal Nursing / Q000379:methods; D017410:Practice Guidelines as Topic
D007213:Indomethacin