5,388 research outputs found
Milk osmolality: does it matter?
No full textHigh osmolality of infant feed reflects a high concentration of solute particles and has been implicated as a cause of necrotising enterocolitis. Evidence for direct intestinal mucosal injury as a result of hyperosmolar feeds is scant, and no good evidence has been found to support such an association. High osmolality of enteral substrate may, however, slow down gastric emptying. Osmolality of current infant feeds ranges from around 300 mOsm/kg in human breast milk to just more than 400 mOsm/kg in fully fortified breast milk. Addition of mineral and vitamin supplements to small volumes of milk can increase osmolality significantly and should be avoided if possible.</p
Preterm birth and body composition at term equivalent age: a systematic review and meta-analysis
No full textThe body composition at TEA of infants born preterm is different than that of infants born at term. Preterm infants have less lean tissue but more similar fat mass. There is a need to determine whether improved nutritional management can enhance lean tissue acquisition, which indicates a need for measures of body composition in addition to routine anthropometr
Early parenteral nutrition and growth outcomes in preterm infants: a systematic review and meta-analysis
No full textBackground: The achievement of adequate nutritional intakes in preterm infants is challenging and may explain the poor growth often seen in this group. The use of early parenteral nutrition (PN) is one potential strategy to address this problem, although the benefits and harms are unknown. Objective: We determined whether earlier administration of PN benefits growth outcomes in preterm infants. Design: We conducted a systematic review of randomized controlled trials (RCTs) and observational studies. Results: Eight RCTs and 13 observational studies met the inclusion criteria (n = 553 and 1796 infants). The meta-analysis was limited by disparate growth-outcome measures. An assessment of bias was difficult because of inadequate reporting. Results are given as mean differences (95% CIs). Early PN reduced the time to regain birth weight by 2.2 d (1.1, 3.2 d) for RCTs and 3.2 d (2.0, 4.4 d) in observational studies. The maximum percentage weight loss with early PN was lower by 3.1 percentage points (1.7, 4.5 percentage points) for RCTs and by 3.5 percentage points (2.6, 4.3 percentage points) for observational studies. Early PN improved weight at discharge or 36 wk postmenstrual age by 14.9 g (5.3, 24.5 g) (observational studies only), but no benefit was shown for length or head circumference. There was no evidence that early PN significantly affects risk of mortality, necrotizing enterocolitis, sepsis, chronic lung disease, intraventricular hemorrhage, or cholestasis. Conclusions: The results of this review, although subject to some limitations, show that early PN provides a benefit for some shortterm growth outcomes. No evidence that early PN increases morbidity or mortality was found. Neonatal research would benefit from the development of a set of core growth outcome measures.</p
Nutrition and neurodevelopmental outcomes in preterm infants: a systematic review
No full textA systematic review with meta-analysis was carried out to investigate the effects of increased nutritional intake, via either macronutrient or multi-nutrient intervention, during the neonatal period on neurodevelopmental outcomes in infants born at <32 weeks of gestation or weighing <1501g at birth.Conclusion: Although the relationship remains unclear, increased early nutrition may reduce neurodevelopmental impairment in this group of infants. Future research should focus on using standardised nutritional interventions and an agreed neurodevelopmental assessment battery
How to use: nutritional assessment in neonates
No full textAdequate nutrition and growth during the neonatal period are important, especially for preterm infants, for whom there is evidence of poor nutrient intakes and growth, and this has important implications for their health in later life. Increased nutritional support while on the neonatal intensive care unit has been shown to improve growth, but such support is not universally available. Being able to carry out and interpret a nutritional assessment is therefore an important skill for paediatricians caring for neonates. This article aims to explain how to use nutritional assessment in neonates and provides some tools to make this process as straightforward as possible.</p
Developing the role of the nurse as a link advisor for research and a champion for nutrition in the neonatal intensive care unit
No full textA unique local practice initiative to develop a small group of nurses in the dual role of link advisors and champions for nutrition was part of a larger research project aimed at standardising nutritional care of preterm infants. Building upon the expertise of a small group of dedicated neonatal nurses, new clinical guidelines were successfully introduced and to date an incremental change in practice achieved. Furthermore, quality outcomes in terms of improving the research profile, bridging the research-practice gap, increased job satisfaction and personal practitioner recognition and achievement has contributed to the success of the project.</p
Combating stem and leaf rust of wheat: Historical perspective, impacts, and lessons learned
No full textmillions fed, food security, wheat rust, stem rust, leaf rust, Norman Borlaug,
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