289 - Helping babies grow- are we setting babies up for success post discharge?

Poster Number: 289
Publication Number: 289.120

Geetika Kennady, Thomas Jefferson/ Nemours/ ChristianaCare, Swedesboro, NJ, United States; Alina ivashchuk, CHOP/Lancaster General Hospital, Ephrata, PA, United States; Bridget M. Storm, Christiana Care, Wilmington, DE, United States; Amy Mackley, Christiana Care Health System, Newark, DE, United States; Carlos Duran, Christiana Care Health System, Newark, DE, United States; Deborah Tuttle, Christiana Care Health System, Newark, DE, United States

Background: Preterm infants have higher nutritional requirements. Fortified breastmilk (BM) and preterm formulas may not meet the recommended daily intake (RDI) of nutrients. In addition, fortified BM are stopped prior to discharge, placing infants at risk for growth restriction and nutritional deficiencies.

Objective: To determine the differences between RDI and actual nutrients in discharge feeds of very low birthweight (VLBW) infants.

Design/Methods: Retrospective chart analysis on 105 infants who were discharged from a tertiary NICU between 2017 and 2019. Nutritional gap analysis was completed at 1 week prior and at the time of discharge by the NICU nutritional specialists. Growth parameters, feeding type and volumes and nutrients were collected. The amount of energy, protein, calcium, phosphorus, and vitamins in the infants’ diet was calculated using this data.

Results: The goal RDI was not met for energy in 32% vs 42%, protein in 30% vs 37%, calcium in 38% vs 35%, phosphorus in 26% vs 29% and vitamin D in 28% versus 24% infants at the time of discharge and 1 week prior to discharge. This was despite only 20% of infants were receiving >75% of their diet as maternal breast milk feedings. At the time of discharge, 19% of the infant's born small for gestational age (SGA) remained SGA and 32% of appropriate for gestational age (AGA) infants were SGA.Conclusion(s): The discharge diet in VLBW babies was insufficient to meet the RDI in more than 30% of babies. Optimizing discharge nutrition is important to achieve optimal growth, bone mineralization and developmental outcomes. Measures to support maternal BM feeds, balancing with nutritional needs must be strengthened.
Geetika Kennady CVGeetika job CV.pdf
Prevalence of maternal breast milk (MBM) feeds