Opportunities, Barriers and Pitfall of Current Nutritional Practice in Preterm Infants

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About this Research Topic

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Background

With the development of neonatal-perinatal medicine, the survival rate of preterm infants is increasing year by year. Reasonable nutritional strategy is one of the key factors to improve the survival rate of preterm infants. Nutrition is not only related to the short-term growth and development of preterm infants, but also affects the long-term prognosis. Therefore, adequate and standardized nutrition management is the basis to ensure the healthy growth of preterm infants.

However, current nutritional practice in preterm infants remains poorly standardized, which needs to be improved. Investigating the status quo can help clinicians assess their practices with respect to published recommendations, understand the gap between the current nutrition practice and the available nutrition guidelines, and identify barriers of implementation of these guidelines.

Prolonged enteral nutrition is due to inconsistent management of issues, such as feed initiation, feed advancement and feed intolerance, increase of the time of total parenteral nutrition (TPN). Prolonged TPN can lead to an increase in TPN related complications, such as parenteral nutrition associated cholestasis, metabolic bone disease, kidney injury, et al. Quality improvement (QI) methodology has been used to reduce time to full feeds for preterm infants through the implementation of evidence-based feeding guidelines.

The goal of this Research Topic is to investigate the status quo of parenteral and enteral nutrition and implement quality improvement to increase the level of nutrition management.

Original research and review articles will be considered on the following specific themes:
• Status quo of parenteral and enteral nutrition of preterm infants.
• Breastfeeding strategies for preterm infants in the NICU.
• Human milk fortification for the preterm infants.
• Role of colostrum and breast milk (own mother’s milk, donor bank milk) on the rates of necrotizing enterocolitis (NEC), late-onset sepsis, and possibly bronchopulmonary dysplasia, as well as long term neurodevelopment outcome.
• Quality improvement to reduce time to full feeds for preterm infants.
• Compliance to nutritional guidelines with a multifaceted quality improvement program, such as: increasing availability of pumps; initiating early human milk expression; oropharyngeal administration of colostrum; standardized enteral feeding guideline; increase breast milk use.

Keywords: Nutrition, Infants, Breastfeeding, Fortification, Parenteral nutrition, Enteral nutrition

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