Browsing by Author "Reeding, Renette Andrea"
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- ItemThe nutrient intakes and feeding prescriptions of low birth weight infants at Chris Hani Baragwanath Academic Hospital(Stellenbosch : Stellenbosch University, 2017-12) Reeding, Renette Andrea; Van Niekerk, Evette; Kemp, Hannelie; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Human Nutrition.ENGLISH SUMMARY : Objectives: To compare feeding prescriptions and actual nutrient intakes of premature, low birth weight (LBW) infants admitted to a tertiary hospital to international recommendations. Methods: An observational, prospective study was undertaken. Patients consecutively admitted to the neonatal intensive care unit who met the inclusion criteria were enrolled. The infants’ feeding prescriptions and intakes were obtained from hospital files and feeding charts on study days one, two, three, seven and 14 of life. Fluid, energy and macronutrient intake from intravenous (IV) fluids, parenteral and enteral feeds were calculated and compared with internationally recognised recommendations. Enteral feed advancements were assessed to determine whether full enteral feeds had been achieved on days seven and 14. Weight, length and head circumference (HC) were measured weekly. Results: A total of 156 preterm infants (56% female; 44% male), with a mean gestational age of 30 weeks were included. The mean birth weight (BW), length and HC were 1 352g, 38.5cm and 28cm respectively. The majority of feeds prescribed (79.10 ml/kg/day) and intakes (34.93 ml/kg/day) on day one were in IV fluid form. Parenteral nutrition (PN) feed prescriptions only met a third of the recommended requirements of the infants (49.94 ml/kg/day, n = 6). Only minimal enteral feeds (24.13 ml/kg/day, n = 48) were prescribed, of which hardly any was administered. Thereafter, prescriptions and intakes for IV, PN and enteral nutrition (EN) were increased. By day seven, parenteral and enteral prescriptions and intakes were inadequate and not comparable to recommendations (p < 0.05). Enteral prescriptions and intakes had only met recommendations by day 14. Differences were seen between the enteral prescriptions and intakes on all study days for all BW categories, but were relatively comparable on day 14. Differences in fluid advancements were found between day one, two and three, and between day seven and 14 for prescriptions and intakes. By day seven and 14, decreased z-scores were observed for all anthropometry. Enteral intakes had a more positive impact (p < 0.05) on percentage weight loss on day seven than on day 14. Parenteral intakes in the VLBW group significantly influenced the regaining of BW on day 14 (p < 0.05). Conclusion: This study showed that premature infants do not meet their nutritional requirements in the current clinical setting, with differences noted between prescriptions and intakes. Inadequate nutrition further exacerbates these infants poor growth seen during the first two weeks of life as seen by either slow feed advancements or majority of infants not on full enteral feeds by day 14.