Poster Topical Area: Maternal, Perinatal and Pediatric Nutrition
Location: Hall D
Poster Board Number: 264
Objective: Preterm newborns 32 weeks gestational age (GA) or less are at increased risk for multiple comorbidities due to immature cardiac, respiratory, renal and gastrointestinal systems. Post-natal growth in preterm newborns is achieved with more positive results when using mother's own milk (MOM). When MOM is unattainable or contraindicated, pasteurized donor breast milk (DBM) is available as a substitute. Because use of DBM within Neonatal Intensive Care Units (NICUs) is relatively new the objective of this investigation was to explore current feeds and growth data to inform a process of future data collection.
Method: De-identified data from 61 extremely low birth weight (ELBW), very low birth weight (VLBW) and micro-preemie preterm newborns were explored via retrospective descriptive analysis. Variables of interest were body weight, GA, time of initiation and extent on DBM, and weight gain.
Results: Goal feeds volume was determined to be 140-170 mL/kg/day and goal weight gain was 15-20g/kg/day on average. The micro-preemie group received feeds at goal volume 34% of the time and met the weight gain goal 30% of the time over 11 weeks. The weeks of best weight gain matched the weeks when the highest volume of feeds was received. The ELBW group averaged feeds at goal volume 70% of the time and met the weight gain goal 34% of the time over 8 weeks. The best weeks of weight gain did not match the period when the highest volume of feeds was received. This outcome may be related to advancing toward goal volume for feeds without fortifying to meet the goal calories per ounce of feeds. The VLBW group averaged feeds at goal volume 56% of the time and met the weight gain goal 21% of the time over 7 weeks. Again, this outcome may be related to advancing to goal volume of feeds before fortification.
Conclusions: Number of days on DBM and the timing of DBM initiation for feeds did not appear to affect weight gain of the neonates. The micro-preemie group received the most consistent amount of feeds volume corresponding with amount of weight gain, which may be due stricter adherence to feeding guidelines. A standardized data collection tool and protocol are needed for accurate monitoring of feeds and growth parameters. Electronic medical records (EMR) can be used if standardized charting is instituted.
Keywords: donor breast milk, preterm newborn.
University of Arkansas for Medical Sciences
Little Rock, Arkansas