title: A Novel Approach to Improving Fat Delivery in Neonatal Enteral Feeding.
abstract: Continuous infusion systems used for enteral nutrition support in the neonatal intensive care unit deliver as little as 60% of the fat in human milk to the neonate. This study determined the effect of mixing common feedings for preterm infants in the feeding bag and tubing on fat losses during enteral feeding. Laboratory models were developed to assess the contribution of various mixing techniques to delivered fat content. Fat content was measured periodically during feeding and compared to baseline measurements. A multistage approach incorporating a feeding bag inverter and a tubing circulation loop delivered >90% of milk fat when used in conjunction with a commercial continuous infusion system. With unfortified human milk, this approach delivered 91.9% ± 1.5% of fat content over a one hour feed, significantly greater (p < 0.01) than 77.5% ± 2.2% delivered by continuous infusion controls (Mean ± SEM). With fortified human milk, this approach delivered 92.1% ± 2.4% of fat content, significantly greater (p < 0.01) than 79.4% ± 1.0% delivered by a non-adapted infusion system (Mean ± SEM). Mixing human milk during continuous infusion improves fat delivery, which may improve nutrition and growth outcomes in low birth weight neonates.
authors.affiliation: Department of Bioengineering, Rice University, Houston, TX 77005, USA. jane.jarjour@alumni.rice.edu.|Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA. jane.jarjour@alumni.rice.edu.
authors.forename: Jane
authors.initials: J
authors.lastname: Jarjour
authors.affiliation: Department of Bioengineering, Rice University, Houston, TX 77005, USA. juarezam@ymail.com.|Beyond Traditional Borders, Rice University, Houston, TX 77005, USA. juarezam@ymail.com.
authors.forename: Alexa M
authors.initials: AM
authors.lastname: Juarez
authors.affiliation: Department of Bioengineering, Rice University, Houston, TX 77005, USA. Denizen.Kocak@utsouthwestern.edu.|Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA. Denizen.Kocak@utsouthwestern.edu.
authors.forename: Denizen K
authors.initials: DK
authors.lastname: Kocak
authors.affiliation: Department of Bioengineering, Rice University, Houston, TX 77005, USA. teamnutriflow@gmail.com.|Department of Medicine, Imperial College London, London W12 0NN, UK. teamnutriflow@gmail.com.
authors.forename: Nathan J
authors.initials: NJ
authors.lastname: Liu
authors.affiliation: Department of Bioengineering, Rice University, Houston, TX 77005, USA. tabata@alumni.rice.edu.|School of Medicine, Stanford University, Stanford, CA 94305, USA. tabata@alumni.rice.edu.
authors.forename: Mika M
authors.initials: MM
authors.lastname: Tabata
authors.affiliation: Section of Neonatology, Department of Pediatrics, The University of Texas at Austin Dell Medical School, Austin, TX 77030, USA. keli.hawthorne@austin.utexas.edu.
authors.forename: Keli M
authors.initials: KM
authors.lastname: Hawthorne
authors.affiliation: Department of Bioengineering, Rice University, Houston, TX 77005, USA. rfr1@rice.edu.
authors.forename: Renata F
authors.initials: RF
authors.lastname: Ramos
authors.affiliation: Section of Neonatology, Department of Pediatrics, The University of Texas at Austin Dell Medical School, Austin, TX 77030, USA. sabrams@austin.utexas.edu.
authors.forename: Steven A
authors.initials: SA
authors.lastname: Abrams
mesh_terms: D004041:Dietary Fats / Q000008:administration & dosage*; D004750:Enteral Nutrition / Q000379:methods*; D004867:Equipment Design; D005527:Food, Fortified; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007234:Infant, Premature / Q000254:growth & development; D019102:Infant, Very Low Birth Weight / Q000254:growth & development; D007363:Intensive Care Units, Neonatal; D008895:Milk, Human
chemical_list: D004041:Dietary Fats
keywords: breast milk; enteral nutrition; human milk-derived fortifier; neonatal intensive care units; neonates; nutriflow; very low birth weight