Nutritional Management for Intolerance to Human Milk Fortifier in a Preterm Small-for-Gestational-Age Infant: a Case Report

Respiratory and Gastrointestinal Management of an Infant with a Birth Weight of 258 Grams

Today, more infants weighing less than or equal to 300 g are born, and they survive because of the improvements in neonatal care and treatment. However, their detailed clinical course and neonatal intensive care unit management remain unknown due to their low survival rate and dearth of reports. A male infant was born at 24 weeks and 5 days of gestation and weighed 258 g. The infant received 72 days of invasive and 92 days of noninvasive respiratory support, including high-frequency oscillatory ventilation with volume guarantee and noninvasive neurally adjusted ventilatory assist. Meconium-related ileus was safely treated using diatrizoate. Although the infant was diagnosed with severe bronchopulmonary dysplasia and retinopathy of prematurity requiring laser photocoagulation, he had no other severe complications. He was discharged 201 days postdelivery (3 months of corrected age) with a weight of 3.396 kg. Although managing infants weighing less than or equal to 300 g is difficult, our experience shows that it is possible by combining traditional and modern management methods. The management of such infants requires an understanding of the expected difficulties and adaptation of existing methods to their management. The management techniques described here should help improve their survival and long-term prognosis.

Analysis on the Application Effect of Abdominal Acupoint Massage on Feeding Intolerance in Premature Infants

Objective

Breast milk is the best food for newly born infants because it is more digestible and can relieve infants' gastrointestinal burdens. The purpose of this study was to investigate the application effect of abdominal acupoint massage on feeding intolerance in premature infants.

Methods

A total of 50 premature infants with feeding intolerance admitted to our hospital from January 2018 to October 2019 were selected and randomly divided into the control group (n = 25) and the experimental group (n = 25). Among them, the premature infants in the control group received routine therapy, while based on the treatment in the control group, the premature infants in the experimental group were treated with abdominal acupoint massage. After that, the incidence of feeding intolerance, MNA nutritional status score, body mass, development state, length of hospital stay, and response rate were all compared between the two groups to analyze the application effect of abdominal acupoint massage on feeding intolerance in premature infants.

Results

The incidence of feeding intolerance of the premature infants in the experimental group was significantly lower than that in the control group, with statistically significant differences (P < 0.05); the MNA nutritional status scores of the premature infants in the experimental group were significantly higher than those in the control group, with statistically significant differences (P < 0.05); the body mass and development state of the premature infants in the experimental group were significantly better than those in the control group, with statistically significant differences (P < 0.05); the length of hospital stay of the premature infants in the experimental group was significantly shorter than that in the control group, with statistically significant differences (P < 0.05); the response rate in the experimental group was significantly higher than that in the control group, with statistically significant differences (P < 0.05).

Conclusions

Abdominal acupoint massage therapy can significantly reduce the incidence of feeding intolerance, shorten the length of hospital stay, and improve nutritional status, development state, and response rate in premature infants, with obvious therapeutic effect, which is worthy of application and promotion in clinical practice.