Feeding premature infants

Role of newborn nurses in newborn feeding

OBJECTIVE

The aim of this study was to determine the function of newborn nurses given at newborn feeding in the newborn units of public hospitals in Konya, Turkey, besides it was also to determine the effect of nurses which had short-term training, aka education, in practice and in theory.

METHODS

This was an experimental study conducted with a total of 50 newborn nurses between 15 September 2004 and 30 February 2005. In collecting the data, a survey sheet including the demographic characteristics of newborn nurses and their knowledge on newborn feeding was applied, along with another remark form that shows clinical practices about newborn feeding.

RESULTS

Considering the nurses, their knowledge mean score 'after education (AE)' was calculated to be 72.4 ± 10.4, which was significantly higher than that of 'before education (BE)', which was 58.0 ± 9.3, (p < 0.05). Likewise, the implementation mean score of these nurses AE (57.2 ± 4.9) was also found higher than the mean score BE (54.4 ± 5.0) (p < 0.05). There were statistically significant differences in the posteducation mean scores of nurses for the number of children they had, and for the hospital they work.

CONCLUSION

In this study, it was determined that the nurses had knowledge deficits about newborn feeding both in theory and practice, but after a short educational program on newborn feeding their theoretical and practical knowledge had shown increases.

Energy expenditure in the extremely low-birth weight infant

Information about energy requirements of extremely low-birth weight infants is sparse, despite the rapidly improving survival rates of this population. Metabolizable energy intake can be estimated from energy balance studies and the percentage of caloric intake that is actually absorbed by these infants is approximately 87%. Data on energy expenditure in extremely premature infants is limited; however, energy expenditure has been shown to increase with postnatal age. Because both intake and expenditure are affected by multiple factors, there is significant variability in estimates of the energy requirements in extremely low-birth weight infants. At present, no valid recommendations can be made regarding optimal energy requirements for the extremely low-birth weight infant, except that their requirements probably exceed those of stable, growing very low-birth weight infants, currently estimated at 105 to 135 kcal.kg-1d-1.

Cisapride: the problem of the heart

Cisapride has been used in the neonatal population as a first-line gastrointestinal prokinetic agent for managing feeding intolerance secondary to decreased gastrointestinal motility. Cisapride acts specifically at many levels of the gastrointestinal tract and has no central nervous system side effects. Recently, prolonged QT interval has been reported secondary to high-dose cisapride, and concerns regarding its use in premature infants have been raised. In response, Janssen-Ortho Inc. and Janssen Pharmaceutica, the manufacturers of cisapride in Canada and the U.S., have released safety information prohibiting the use of cisapride in premature infants. In light of the present evidence, it is imperative that NICUs that continue to prescribe cisapride for the management of feeding intolerance exercise vigilance in cardiac monitoring and recognize the importance of drug interactions that lead to elevated cisapride levels.

Advances in neonatology. View from a practicing pediatrician

After reviewing the many problems that may be seen by the physician in follow-up care of the preterm infant and family, it is important to take a step back and evaluate the infant as a whole. In the vast majority of instances, the preterm infant will turn out to be normal. In an unfortunate minority, there may be difficult problems that the baby, parents, and caretakers must face. The pediatrician must remain diligent to attend to those problems that are correctable and to assist patients to their full potential.