title: Australasian neonatal intensive care enteral nutrition survey: implications for practice.
abstract: OBJECTIVE
  This survey investigated standardised feeding guidelines and nutrition policy in Australasian neonatal intensive care units and compared these with previously published surveys and international consensus nutrition recommendations.
  
  
  METHODS
  An electronic survey on enteral nutrition comprising a wide range of questions about clinical practice was e-mailed to all 25 Australasian neonatal intensive care unit directors of tertiary perinatal centres.
  
  
  RESULTS
  Twenty-five surveys were distributed; 24 (96%) were completed. All respondents preferred breast milk as the first feed. For infants <1000 g, 58% started feeds at 1 mL every 4 hours and 83% started enteral feeds on day 0-2 in the absence of contraindications. The identification of bile-stained gastric aspirates significant enough to withhold feeds varied. Multicomponent breast milk fortifiers were added by 58% when enteral feeds reached 150 mL/kg day, while 21% added these earlier at 120 mL/kg day or less. Iron supplementation was started at 4 weeks by 63% and at 6 weeks by 27%. Only 42% of units had a neonatal dietitian. Of the 24 units who responded, 58% had no written enteral feeding guidelines.
  
  
  CONCLUSIONS
  Enteral nutrition was initiated earlier than in the past. Great variation remains in clinical practices. Nutritional implications are discussed. Standardisation of feeding guidelines and enteral nutrition policy based on current evidence and international consensus nutrition recommendations may be beneficial and should be encouraged.
authors.affiliation: Auckland City Hospital, Auckland, New Zealand. bcormack@adhb.govt.nz
authors.forename: Barbara
authors.initials: B
authors.lastname: Cormack
authors.forename: John
authors.initials: J
authors.lastname: Sinn
authors.forename: Kei
authors.initials: K
authors.lastname: Lui
authors.forename: David
authors.initials: D
authors.lastname: Tudehope
mesh_terms: D044362:Australasia; D004750:Enteral Nutrition / Q000592:standards* / Q000706:statistics & numerical data; D005527:Food, Fortified / Q000009:adverse effects / Q000592:standards* / Q000706:statistics & numerical data; D017408:Guidelines as Topic; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development* / Q000502:physiology; D007363:Intensive Care Units, Neonatal / Q000592:standards / Q000706:statistics & numerical data; D008895:Milk, Human; D009749:Nutrition Surveys; D009751:Nutritional Requirements