Somatic growth of enteral-only fed extremely low birth weight infants in a resource-restricted setting
Date
2021-04
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University, 2021
Abstract
ENGLISH ABSTRACT: Aim: To determine the growth and prevalence of extrauterine growth restriction (EUGR) in extremely low birth weight (ELBW) infants receiving enteral-only nutrition in a resource-restricted environment. Methods: In 72 ELBW (<1000g) infants, admitted over a one-year period to Tygerberg Hospital, Cape Town, South Africa, information on nutritional intake, largely from fortified breastmilk was retrospectively collected. Anthropometric data for the first 49 postnatal days was compared to gender-specific INTERGROWTH-21st standards. Results: Full enteral feeds (150 ml/kg) were reached by day 10-14 with energy >100 Kcal/kg/day from day 10, and protein >3.5mg/kg/day from day 14, onwards. Growth velocity remained below 15g/kg/day at day 49. INTERGROWTH-21st Z-scores decreased from -0.8 ± 1.1 at birth to -2.4 ± 1.5 at day 49. Adequate weight growth velocity (≥15g/kg/d) was associated with maternal hypertension, completed antenatal steroids, caesarean section delivery, and small for gestational age status. Conclusion: This is the first study to evaluate growth of ELBW infants in a resource-restricted setting where enteral-only nutrition, principally from fortified breastmilk, was the primary feeding option. The incidence of EUGR, although high, was similar to the incidence in well-resourced settings, where total parenteral nutrition is routinely provided.
Key notes: Extra-uterine growth restriction (EUGR) is high in extremely low birth weight infants receiving enteral-only nutrition. However, EUGR rates are similar to infants receiving parenteral nutrition. Despite developmental immaturity it is possible for these infants to achieve fetal growth rates. Enteral-only feeding regimens, especially in restricted-resource environments, should be regularly audited to ensure provision of feeds with optimal protein, and protein to energy ratios.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.
Description
Thesis (MMed)--Stellenbosch University, 2021
Keywords
Somatic growth, Birth weight, Low, Enteral feeding of children, Fetus -- Growth, UCTD