title: Guidelines for feeding very low birth weight infants.
abstract: Despite the fact that feeding a very low birth weight (VLBW) neonate is a fundamental and inevitable part of its management, this is a field which is beset with controversies. Optimal nutrition improves growth and neurological outcomes, and reduces the incidence of sepsis and possibly even retinopathy of prematurity. There is a great deal of heterogeneity of practice among neonatologists and pediatricians regarding feeding VLBW infants. A working group on feeding guidelines for VLBW infants was constituted in McMaster University, Canada. The group listed a number of important questions that had to be answered with respect to feeding VLBW infants, systematically reviewed the literature, critically appraised the level of evidence, and generated a comprehensive set of guidelines. These guidelines form the basis of this state-of-art review. The review touches upon trophic feeding, nutritional feeding, fortification, feeding in special circumstances, assessment of feed tolerance, and management of gastric residuals, gastro-esophageal reflux, and glycerin enemas.
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University Children's Hospital, Hamilton L8S4L8, Ontario, Canada. sdutta@mcmaster.ca.
authors.forename: Sourabh
authors.initials: S
authors.lastname: Dutta
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University Children's Hospital, Hamilton L8S4L8, Ontario, Canada. drbalpreetsingh@yahoo.com.
authors.forename: Balpreet
authors.initials: B
authors.lastname: Singh
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University Children's Hospital, Hamilton L8S4L8, Ontario, Canada. chessell@HHSC.CA.
authors.forename: Lorraine
authors.initials: L
authors.lastname: Chessell
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University Children's Hospital, Hamilton L8S4L8, Ontario, Canada. wilsonj@HHSC.CA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Wilson
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University Children's Hospital, Hamilton L8S4L8, Ontario, Canada. janes@HHSC.CA.
authors.forename: Marianne
authors.initials: M
authors.lastname: Janes
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University Children's Hospital, Hamilton L8S4L8, Ontario, Canada. mcdonk@HHSC.CA.
authors.forename: Kimberley
authors.initials: K
authors.lastname: McDonald
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University Children's Hospital, Hamilton L8S4L8, Ontario, Canada. shahidsattar75@yahoo.com.
authors.forename: Shaneela
authors.initials: S
authors.lastname: Shahid
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University Children's Hospital, Hamilton L8S4L8, Ontario, Canada. gardner@hhsc.ca.
authors.forename: Victoria A
authors.initials: VA
authors.lastname: Gardner
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University Children's Hospital, Hamilton L8S4L8, Ontario, Canada. hjartar@hhsc.ca.
authors.forename: Aune
authors.initials: A
authors.lastname: Hjartarson
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University Children's Hospital, Hamilton L8S4L8, Ontario, Canada. purcham@HHSC.CA.
authors.forename: Margaret
authors.initials: M
authors.lastname: Purcha
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University Children's Hospital, Hamilton L8S4L8, Ontario, Canada. wilsonj@HHSC.CA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Watson
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University Children's Hospital, Hamilton L8S4L8, Ontario, Canada. deboerc@hhsc.ca.
authors.forename: Chris
authors.initials: C
authors.lastname: de Boer
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University Children's Hospital, Hamilton L8S4L8, Ontario, Canada. B.Gaal@bell.net.
authors.forename: Barbara
authors.initials: B
authors.lastname: Gaal
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University Children's Hospital, Hamilton L8S4L8, Ontario, Canada. fusch@mcmaster.ca.
authors.forename: Christoph
authors.initials: C
authors.lastname: Fusch
mesh_terms: D001942:Breast Feeding; D002170:Canada; D004733:Enema; D004750:Enteral Nutrition / Q000379:methods / Q000592:standards*; D005312:Fetal Blood / Q000378:metabolism; D005527:Food, Fortified; D005764:Gastroesophageal Reflux / Q000178:diet therapy / Q000188:drug therapy; D005990:Glycerol / Q000008:administration & dosage; D006801:Humans; D007022:Hypotension / Q000178:diet therapy; D007052:Ibuprofen / Q000008:administration & dosage; D007213:Indomethacin / Q000008:administration & dosage; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development; D019102:Infant, Very Low Birth Weight / Q000254:growth & development*; D015201:Meta-Analysis as Topic; D008895:Milk, Human; D018673:Nutrition Policy; D009752:Nutritional Status; D016032:Randomized Controlled Trials as Topic; D014691:Ventilation
chemical_list: D005990:Glycerol; D007052:Ibuprofen; D007213:Indomethacin