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The nutrient intakes and feeding prescriptions of low birth weight infants at Chris Hani Baragwanath Academic Hospital

dc.contributor.advisorVan Niekerk, Evetteen_ZA
dc.contributor.advisorKemp, Hannelieen_ZA
dc.contributor.authorReeding, Renette Andreaen_ZA
dc.contributor.otherStellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Human Nutrition.en_ZA
dc.date.accessioned2017-09-07T13:53:25Z
dc.date.accessioned2017-12-11T10:28:51Z
dc.date.available2019-11-01T03:00:07Z
dc.date.issued2017-12
dc.identifier.urihttp://hdl.handle.net/10019.1/102588
dc.descriptionThesis (MNutr)--Stellenbosch University, 2017.en_ZA
dc.description.abstractENGLISH 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.en_ZA
dc.description.abstractAFRIKAANSE OPSOMMING : Doelwitte: Om die voedings voorskrifte en werklike nutriënt innames van lae geboorte massa (LGM) babas wat in ‘n tersiêre hospital opgeneem is, met aanbevole riglyne te vergelyk, en om vas te stel of nutriënt innames ‘n impak op gewigsverlies na geboorte en die herwinning van geboorte massa gehad het. Metodologie: ‘n Prospektiewe waarnemende studie is onderneem. Pasiënte wat opeenvolgend in die neonatale intensiewe sorg eenheid opgeneem is en aan insluitings kriteria voldoen het, is in die studie ingesluit. Voedings voorskrfte en nutrient innames is op dag een, twee, drie, sewe en 14 van lewe vanuit hospitaal rekords en voedingskaarte bekom. Vloeistof, energie en makronutriënt inname is vanaf intraveneuse vog, parenterale en enterale voedings bereken en met internasionaal erkende aanbevelings vergelyk. Die tempo waarteen enterale voedings verhoog is, is vasgestel om te bepaal of vol voedings op dag sewe en 14 bereik is. Massa, lengte en kopomtrek is weekliks gemeet om die impak van voeding op die persentasie massaverlies en herwinning van geboorte massa vas te stel. Resultate: ‘n Totaal van 156 premature babas (46% vroulik; 44% manlik) met ‘n gemiddelde gestasie ouderdom van 30 weke is ingesluit. Die gemiddelde geboorte massa, lengte en kopomtrek was respektiewelik 1352g, 38.5cm en 28cm. Die meerderheid voedings wat op dag een voorgeskryf (79.10 ml/kg/dag) en ingeneem (34.93 ml/kg/dag) is, was vanaf intraveneuse vog. Dertig persent van aanbevole totale parenterale voeding (49.94 ml/kg/dag, n = 6) en minimale enterale voeding (24.13 ml/kg/dag; n = 48) is voorgeskryf, maar bykans geen enterale voeding is ontvang nie. Daarna is voorskrifte en innames van intraveneuse, parenterale en enterale voeding verhoog. Teen dag sewe was parenterale en enterale voorskrifte en innames onvoldoende en nie vergelykbaar met aanbevelings nie (p < 0.05). Enterale voorskrifte en innames het eers teen dag 14 die aanbevelings bereik. Verskille is op alle studie dae tussen die enterale voorskrifte en innames vir alle geboorte massa groepe gesien. Verskille in die verhogings van vloeistof is tussen dag een, twee en drie en tussen dag sewe en 14 vir voorskrifte en innames waargeneem. Verlaagde Z-tellings is gedurende die twee weke vir massa, lengte en kopomtrek waargeneem. Enterale nutriënt innames het ‘n groter impak (p < 0.05) op persentasie massaverlies op dag sewe as op dag 14 gehad. In die baie lae geboorte massa groep het parenterale nutriënt innames die herwinning van geboorte massa betekenisvol beïnvloed (p < 0.05). Gevolgtrekking: Hierdie studie het getoon dat in die huidige kliniese opset daar nie aan die voedings voorskrifte en nutriȅnt innames van lae geboorte massa premature babas voldoen word nie. Stadige verhoging van voedings teikenend van ontoereikende voeding in die oorgrote meerderheid van hierdie babas, vererger die babas se swak groei gedurende die eerste twee weke van lewe.af_ZA
dc.format.extentxix, 148 pages ; illustrations, includes annexures
dc.language.isoen_ZAen_ZA
dc.publisherStellenbosch : Stellenbosch Universityen_ZA
dc.subjectPremature infants -- Nutrition -- Chris Hani Baragwanath Hospital -- Gauteng (South Africa)en_ZA
dc.subjectBirth weight, Low -- Chris Hani Baragwanath Hospital -- Gauteng (South Africa)en_ZA
dc.subjectEnteral feeding -- Formulae, receipts, prescriptions -- Chris Hani Baragwanath Hospital -- Gauteng (South Africa)en_ZA
dc.subjectUCTD
dc.titleThe nutrient intakes and feeding prescriptions of low birth weight infants at Chris Hani Baragwanath Academic Hospitalen_ZA
dc.typeThesisen_ZA
dc.description.versionMasters
dc.rights.holderStellenbosch Universityen_ZA
dc.embargo.terms2019-11-01


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