title: Impact of standardized feeding guidelines on enteral nutrition administration, growth outcomes, metabolic bone disease, and cholestasis in the NICU.
abstract: OBJECTIVE
  The objectives of this study were to determine whether the implementation of standardized feeding guidelines (SFGs) in a neonatal intensive care unit had an impact on the administration of enteral nutrition, growth, and bone and liver health.
  
  
  METHODS
  This was a retrospective chart review of infants ≤ 32 weeks' gestation and ≤ 1500 g at birth who received enteral nutrition either via traditional care (TC) or via SFGs. The outcomes of the study were to determine the day of life the first enteral feedings were started, the day of life full, fortified enteral feedings were established, the day of life the infant returned to birth weight, the change in weight z score from birth to day of life 30, and the presence of metabolic bone disease and cholestasis.
  
  
  RESULTS
  There were 128 infants in the TC group and 125 infants in the SFG group. Based on the Cox regression, no significant differences were found between the 2 groups in the length of time to the first feed (P=0.110; CI 1.03-1.70), in the length of time to full, fortified enteral feedings (P=0.334; CI 0.87-1.44), in the length of time to return to birth weight (P=0.545; CI 0.77-1.28), incidence of metabolic bone disease (P=0.990), or incidence of cholestasis (P=0.926).
  
  
  CONCLUSIONS
  This study provides preliminary evidence that SFGs have an effect on enteral nutrition administration, growth, and morbidity for preterm infants. Although the findings were not statistically significant, they are clinically relevant.
authors: *Abbott Nutrition, Clifton Park, NY †Department of Nutritional Sciences ‡Programs in Clinical Nutrition §Department of Quantitative Methods, School of Public Health, University of Medicine and Dentistry, Newark, NJ.
authors: Theresa
authors: T
authors: Loomis
authors: Laura
authors: L
authors: Byham-Gray
authors: Jane
authors: J
authors: Ziegler
authors: James S
authors: JS
authors: Parrott
mesh_terms: D000367:Age Factors; D001724:Birth Weight; D001851:Bone Diseases, Metabolic / Q000453:epidemiology*; D002657:Child Development; D002779:Cholestasis / Q000453:epidemiology*; D004750:Enteral Nutrition / Q000379:methods / Q000592:standards*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D015994:Incidence; D062071:Infant, Extremely Premature / Q000254:growth & development; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D007363:Intensive Care Units, Neonatal; D008297:Male; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D013997:Time Factors; D015430:Weight Gain