title: Early, rapidly progressive enteral nutrition promotes growth of very low birth weight (VLBW) infants.
abstract: OBJECTIVE
  This study describes the effects of a quality improvement program to promote improved postnatal nutrition on the growth of very low birth weight (VLBW) infants.
  
  
  METHODS
  Daily data regarding nutrition and growth were collected from the medical record of VLBW infants born during 1995-2010. The infants were grouped by year of birth in order to compare infants from before, during and after the policy change. Evaluation of growth included age in days at a return to birth weight and the proportion of infants with weight below the 10th percentile at discharge.
  
  
  RESULTS
  The caloric and protein intake improved significantly. The age at a return to birth weight fell (p < 0.01) from 14.6 ± 5 d to 11 ± 8 d after the change. The proportion of infants with a discharge weight below the 10th percentile for corrected age fell (p < 0.01) from 72.1% to 42.1%. Data on enteral feeding showed that increased rate of enteral feeds (EF) was associated with better growth (p < 0.001).
  
  
  CONCLUSIONS
  Increasing awareness led to increase in caloric and protein intake in VLBW infants. Aggressive EF was associated with more rapid weight gain. However, the provision of protein and calories during the first 2 weeks of life still falls short of the latest European Society of Pediatric Gastroenterology, Hepatology and Nutrition recommendations.
authors.affiliation: a Department of Neonatology , Kaplan Medical Center , Rehovot , Israel.|b Medical School, Hebrew University , Jerusalem , Israel.
authors.forename: Orna
authors.initials: O
authors.lastname: Flidel-Rimon
authors.affiliation: b Medical School, Hebrew University , Jerusalem , Israel.
authors.forename: Moriya
authors.initials: M
authors.lastname: Raz
authors.affiliation: c Department of Pediatrics , Kaplan Medical Center , Rehovot , Israel , and.
authors.forename: Uri
authors.initials: U
authors.lastname: Balla
authors.affiliation: a Department of Neonatology , Kaplan Medical Center , Rehovot , Israel.|c Department of Pediatrics , Kaplan Medical Center , Rehovot , Israel , and.
authors.forename: Lilach
authors.initials: L
authors.lastname: Hofi
authors.affiliation: a Department of Neonatology , Kaplan Medical Center , Rehovot , Israel.
authors.forename: Ada
authors.initials: A
authors.lastname: Juster-Reicher
authors.affiliation: a Department of Neonatology , Kaplan Medical Center , Rehovot , Israel.|d Medical School, Bar-Ilan University , Ramat-Gan , Israel.
authors.forename: Eric S
authors.initials: ES
authors.lastname: Shinwell
mesh_terms: D000704:Analysis of Variance; D002149:Energy Intake / Q000502:physiology*; D004750:Enteral Nutrition / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D005865:Gestational Age; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000254:growth & development*; D008137:Longitudinal Studies; D008297:Male; D016730:Program Development; D058996:Quality Improvement; D012189:Retrospective Studies; D015430:Weight Gain
keywords: Calories; nutritional recommendations; post-natal growth; protein; very low birth weight infants