Energy and Protein Intake During the Transition from Parenteral to Enteral Nutrition in Infants of Very Low Birth Weight

Gustave H. Falciglia*, Karna Murthy, Jane L. Holl, Hannah L. Palac, Yuliya Oumarbaeva, Donna M. Woods, Daniel T. Robinson

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Objective: To evaluate the association between nutrition delivery practices and energy and protein intake during the transition from parenteral to enteral nutrition in infants of very low birth weight (VLBW). Study design: This was a retrospective analysis of 115 infants who were VLBW from a regional neonatal intensive care unit. Changes in energy and protein intake were estimated during transition phase 1 (0% enteral); phase 2 (>0, ≤33.3% enteral); phase 3 (>33.3, ≤66.7% enteral); phase 4 (>66.7, <100% enteral); and phase 5 (100% enteral). Associations between energy and protein intake were determined for each phase for parenteral nutrition, intravenous lipids, central line, feeding fortification, fluid restriction, and excess non-nutritive fluid intake. Results: In phases 2 and 3, infants receiving feeding fortification received less protein than infants who were unfortified (−1.1 and −0.3 g/kg/d, respectively; P <.001). However, this negative association was not observed after adjusting for relevant nutrition delivery practices. Despite greater enteral protein intake during phases 2 and 3 (0.3 and 0.8 g/kg/d, respectively; P <.001), infants with early fortification received less parenteral protein than infants who were unfortified (−1.4 and −1.1 g/kg/d, respectively; P <.001). Similar patterns were observed for energy intake. Protein intake declined during phases 3 and 4. Conclusions: Infants paradoxically received less protein and energy on days with early fortification, suggesting that clinicians may lack easily accessible data to detect the association between nutrition delivery practices and overall nutrition in infants who are VLBW.

Original languageEnglish (US)
Pages (from-to)38-43.e1
JournalJournal of Pediatrics
Volume202
DOIs
StatePublished - Nov 1 2018

Fingerprint

Very Low Birth Weight Infant
Enteral Nutrition
Energy Intake
Small Intestine
Proteins
Neonatal Intensive Care Units
Phase Transition
Parenteral Nutrition
Lipids

Keywords

  • energy
  • factors
  • neonatal
  • NICU
  • phase
  • protein

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

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title = "Energy and Protein Intake During the Transition from Parenteral to Enteral Nutrition in Infants of Very Low Birth Weight",
abstract = "Objective: To evaluate the association between nutrition delivery practices and energy and protein intake during the transition from parenteral to enteral nutrition in infants of very low birth weight (VLBW). Study design: This was a retrospective analysis of 115 infants who were VLBW from a regional neonatal intensive care unit. Changes in energy and protein intake were estimated during transition phase 1 (0{\%} enteral); phase 2 (>0, ≤33.3{\%} enteral); phase 3 (>33.3, ≤66.7{\%} enteral); phase 4 (>66.7, <100{\%} enteral); and phase 5 (100{\%} enteral). Associations between energy and protein intake were determined for each phase for parenteral nutrition, intravenous lipids, central line, feeding fortification, fluid restriction, and excess non-nutritive fluid intake. Results: In phases 2 and 3, infants receiving feeding fortification received less protein than infants who were unfortified (−1.1 and −0.3 g/kg/d, respectively; P <.001). However, this negative association was not observed after adjusting for relevant nutrition delivery practices. Despite greater enteral protein intake during phases 2 and 3 (0.3 and 0.8 g/kg/d, respectively; P <.001), infants with early fortification received less parenteral protein than infants who were unfortified (−1.4 and −1.1 g/kg/d, respectively; P <.001). Similar patterns were observed for energy intake. Protein intake declined during phases 3 and 4. Conclusions: Infants paradoxically received less protein and energy on days with early fortification, suggesting that clinicians may lack easily accessible data to detect the association between nutrition delivery practices and overall nutrition in infants who are VLBW.",
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Energy and Protein Intake During the Transition from Parenteral to Enteral Nutrition in Infants of Very Low Birth Weight. / Falciglia, Gustave H.; Murthy, Karna; Holl, Jane L.; Palac, Hannah L.; Oumarbaeva, Yuliya; Woods, Donna M.; Robinson, Daniel T.

In: Journal of Pediatrics, Vol. 202, 01.11.2018, p. 38-43.e1.

Research output: Contribution to journalArticle

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T1 - Energy and Protein Intake During the Transition from Parenteral to Enteral Nutrition in Infants of Very Low Birth Weight

AU - Falciglia, Gustave H.

AU - Murthy, Karna

AU - Holl, Jane L.

AU - Palac, Hannah L.

AU - Oumarbaeva, Yuliya

AU - Woods, Donna M.

AU - Robinson, Daniel T.

PY - 2018/11/1

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N2 - Objective: To evaluate the association between nutrition delivery practices and energy and protein intake during the transition from parenteral to enteral nutrition in infants of very low birth weight (VLBW). Study design: This was a retrospective analysis of 115 infants who were VLBW from a regional neonatal intensive care unit. Changes in energy and protein intake were estimated during transition phase 1 (0% enteral); phase 2 (>0, ≤33.3% enteral); phase 3 (>33.3, ≤66.7% enteral); phase 4 (>66.7, <100% enteral); and phase 5 (100% enteral). Associations between energy and protein intake were determined for each phase for parenteral nutrition, intravenous lipids, central line, feeding fortification, fluid restriction, and excess non-nutritive fluid intake. Results: In phases 2 and 3, infants receiving feeding fortification received less protein than infants who were unfortified (−1.1 and −0.3 g/kg/d, respectively; P <.001). However, this negative association was not observed after adjusting for relevant nutrition delivery practices. Despite greater enteral protein intake during phases 2 and 3 (0.3 and 0.8 g/kg/d, respectively; P <.001), infants with early fortification received less parenteral protein than infants who were unfortified (−1.4 and −1.1 g/kg/d, respectively; P <.001). Similar patterns were observed for energy intake. Protein intake declined during phases 3 and 4. Conclusions: Infants paradoxically received less protein and energy on days with early fortification, suggesting that clinicians may lack easily accessible data to detect the association between nutrition delivery practices and overall nutrition in infants who are VLBW.

AB - Objective: To evaluate the association between nutrition delivery practices and energy and protein intake during the transition from parenteral to enteral nutrition in infants of very low birth weight (VLBW). Study design: This was a retrospective analysis of 115 infants who were VLBW from a regional neonatal intensive care unit. Changes in energy and protein intake were estimated during transition phase 1 (0% enteral); phase 2 (>0, ≤33.3% enteral); phase 3 (>33.3, ≤66.7% enteral); phase 4 (>66.7, <100% enteral); and phase 5 (100% enteral). Associations between energy and protein intake were determined for each phase for parenteral nutrition, intravenous lipids, central line, feeding fortification, fluid restriction, and excess non-nutritive fluid intake. Results: In phases 2 and 3, infants receiving feeding fortification received less protein than infants who were unfortified (−1.1 and −0.3 g/kg/d, respectively; P <.001). However, this negative association was not observed after adjusting for relevant nutrition delivery practices. Despite greater enteral protein intake during phases 2 and 3 (0.3 and 0.8 g/kg/d, respectively; P <.001), infants with early fortification received less parenteral protein than infants who were unfortified (−1.4 and −1.1 g/kg/d, respectively; P <.001). Similar patterns were observed for energy intake. Protein intake declined during phases 3 and 4. Conclusions: Infants paradoxically received less protein and energy on days with early fortification, suggesting that clinicians may lack easily accessible data to detect the association between nutrition delivery practices and overall nutrition in infants who are VLBW.

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