An observational study of the provision of nutrition to Neonates <34 weeks gestation in the Lyell McEwin Hospital Special Care Nursery

Ritan, A1 & Chiro, L1

1 Lyell McEwin Hospital, NALHN, SA Health

 

Early nutrition interventions for pre-term infants in the first few weeks of life are associated with improved growth and better neurodevelopmental outcomes. This study investigated the types of early nutrition provided to preterm infants <34 weeks gestation within the Special Care Nursery (SCN) and the time taken to meet recommended nutritional requirements. A retrospective audit of eligible individual infant medical records was used to collect primary (timing, types and mode of delivery of feeding interventions) and secondary (growth) measures from 16 preterm infants who met the inclusion criteria.

Enteral nutrition was commenced in all preterm infants. The time of commencement from birth varied and there was no standardised approach to enteral feed upgrade. The mean time to achieve goal rate was 5½ days post-birth. 37.5% received a term infant formula as the first source of enteral feed and 62.5% received expressed breast milk. 75% of preterm infants commenced fortification during their admission with a human milk fortifier or a preterm formula. 87.5% of preterm infants received a first breastfeed attempt at a mean of 5½ days post birth. 75% of pre-term infants met recommended nutritional requirements at a mean age of 7 days post birth. 56% of pre-terms dropped weight Z score between 0.8 – 2 standard deviations. This study concludes that suboptimal nutrition is provided to preterm infants <34 weeks on the SCN. The lack of standardised feeding practices on the unit results in delays meeting nutrition requirements. Further investigation into standardising feeding practices with specialist Dietetic support is recommended.


Anna Ritan is Senior Paediatric Dietitian at Lyell McEwin Hospital (LMH), where Anna provides Dietetic assessment and advice for infants and children presenting with nutrition related concerns. Anna has over ten years of experience working in clinical dietetics and has a keen interest in promoting adequate nutritional intake in early life. Anna provides a consultative role to other staff and disciplines regarding paediatric dietetics. Anna developed and completed this observation study to investigate current practices in the LMH Neonatal ward and to provide a base for ongoing service development.

Lucilla Chiro is Acting Senior Paediatric Dietitian at Lyell McEwin Hospital. Lucilla has ten years’ experience working as a dietitian in inpatient, outpatient and community based sites in Australia and the UK. Lucilla has a keen interest in optimising health outcomes by supporting appropriate nutrition in the first 1000 days of life.

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