Pub Date : 2014-10-01DOI: 10.1177/1941406414539005
M. Kaminski, K. L. Clancy, D. Steward
Providing enteral nutrition to preterm infants is a challenge because of the immaturity of the gastrointestinal tract. Clinicians often take a cautious approach to advancing enteral feedings because of concerns related to development of feeding intolerance or necrotizing enterocolitis. Gastric residuals provide a mechanism for monitoring feeding tolerance since they are easy to obtain and quantify. Despite the common practice of monitoring gastric residuals, there is a lack of agreement in determining when an obtained gastric residual becomes clinically significant. Furthermore, numerous factors can affect the characteristics of the gastric residual. A review of the literature demonstrates significant variability in defining a clinically significant gastric residual. Importantly, there is a lack of available evidence to support selected parameters. Recommendations for practice are discussed.
{"title":"Dilemmas Surrounding Interpretation of Gastric Residuals in the NICU Setting","authors":"M. Kaminski, K. L. Clancy, D. Steward","doi":"10.1177/1941406414539005","DOIUrl":"https://doi.org/10.1177/1941406414539005","url":null,"abstract":"Providing enteral nutrition to preterm infants is a challenge because of the immaturity of the gastrointestinal tract. Clinicians often take a cautious approach to advancing enteral feedings because of concerns related to development of feeding intolerance or necrotizing enterocolitis. Gastric residuals provide a mechanism for monitoring feeding tolerance since they are easy to obtain and quantify. Despite the common practice of monitoring gastric residuals, there is a lack of agreement in determining when an obtained gastric residual becomes clinically significant. Furthermore, numerous factors can affect the characteristics of the gastric residual. A review of the literature demonstrates significant variability in defining a clinically significant gastric residual. Importantly, there is a lack of available evidence to support selected parameters. Recommendations for practice are discussed.","PeriodicalId":398639,"journal":{"name":"ICAN: Infant, Child, & Adolescent Nutrition","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123807468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-10-01DOI: 10.1177/1941406414543493
Blake B. Sparks, P. Radmacher, S. Lewis, L. Serke, D. Adamkin
Objective. To evaluate the contribution of real-time human milk (HM) analysis in the development of individual fortification plans for very low birth weight (VLBW) infants (<1500 g). Methods. Pooled, 24-hour samples of HM were analyzed 1 to 2 times weekly. HM was fortified using 30 kcal/oz preterm formula (PTF) or acidified concentrated liquid formula (ACLF). Daily nutrient intakes, growth, and laboratory data were collected from the week prior to fortification and for the 4 weeks of the study period. Protein (g/kg/day) and energy (kcal/kg/day) intakes were calculated by adding the proportional contributions from HM and fortifier. Results. There were 24 VLBW infants. Both groups (PTF, n = 18; ACLF, n = 6) had similar birth characteristics. HM protein and energy content varied considerably throughout the study. Mean protein intake was significantly higher in infants receiving ACLF (P < 0.001) compared to PTF, while energy intake was similar. The proportion of HM used with ACLF was significantly higher than...
目标。评估实时人乳(HM)分析在极低出生体重(VLBW)婴儿(<1500 g)个体强化计划制定中的贡献。收集24小时的HM样本，每周分析1至2次。HM采用30 kcal/oz早产儿配方(PTF)或酸化浓缩液体配方(ACLF)进行强化。每日营养摄入量、生长和实验室数据从强化前一周和研究期间的4周收集。蛋白质(g/kg/day)和能量(kcal/kg/day)摄取量按比例计算。结果。VLBW婴儿24例。两组(PTF, n = 18;ACLF, n = 6)有相似的出生特征。HM蛋白质和能量含量在整个研究过程中变化很大。与PTF相比，接受ACLF的婴儿平均蛋白质摄入量显著高于PTF (P < 0.001)，而能量摄入量相似。HM与ACLF联合使用的比例显著高于…
{"title":"Human Milk Analysis Contributes to Nutritional Management of Very Low Birth Weight Infants","authors":"Blake B. Sparks, P. Radmacher, S. Lewis, L. Serke, D. Adamkin","doi":"10.1177/1941406414543493","DOIUrl":"https://doi.org/10.1177/1941406414543493","url":null,"abstract":"Objective. To evaluate the contribution of real-time human milk (HM) analysis in the development of individual fortification plans for very low birth weight (VLBW) infants (<1500 g). Methods. Pooled, 24-hour samples of HM were analyzed 1 to 2 times weekly. HM was fortified using 30 kcal/oz preterm formula (PTF) or acidified concentrated liquid formula (ACLF). Daily nutrient intakes, growth, and laboratory data were collected from the week prior to fortification and for the 4 weeks of the study period. Protein (g/kg/day) and energy (kcal/kg/day) intakes were calculated by adding the proportional contributions from HM and fortifier. Results. There were 24 VLBW infants. Both groups (PTF, n = 18; ACLF, n = 6) had similar birth characteristics. HM protein and energy content varied considerably throughout the study. Mean protein intake was significantly higher in infants receiving ACLF (P < 0.001) compared to PTF, while energy intake was similar. The proportion of HM used with ACLF was significantly higher than...","PeriodicalId":398639,"journal":{"name":"ICAN: Infant, Child, & Adolescent Nutrition","volume":"81 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116406519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-10-01DOI: 10.1177/1941406414547761
Suzanne L. Smith, C. Dobbins
Recent studies suggest a dose–response relationship between the amount of human milk received by very low birth weight infants and protection from select prematurity-specific morbidities. However, the feeding of high doses of human milk in this population often is precluded by insufficient maternal milk volume and the replacement of human milk feedings with calorie-dense infant formulas. This article reviews a multidisciplinary quality improvement effort aimed at administering higher enteral volumes of human milk at 1 week of life, 4 weeks of life, and at discharge in the neonatal intensive and progressive care units.
{"title":"Every Drop Counts Protecting High-Risk Neonates With Human Milk","authors":"Suzanne L. Smith, C. Dobbins","doi":"10.1177/1941406414547761","DOIUrl":"https://doi.org/10.1177/1941406414547761","url":null,"abstract":"Recent studies suggest a dose–response relationship between the amount of human milk received by very low birth weight infants and protection from select prematurity-specific morbidities. However, the feeding of high doses of human milk in this population often is precluded by insufficient maternal milk volume and the replacement of human milk feedings with calorie-dense infant formulas. This article reviews a multidisciplinary quality improvement effort aimed at administering higher enteral volumes of human milk at 1 week of life, 4 weeks of life, and at discharge in the neonatal intensive and progressive care units.","PeriodicalId":398639,"journal":{"name":"ICAN: Infant, Child, & Adolescent Nutrition","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122451845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-10-01DOI: 10.1177/1941406414549289
C. McPherson, Ann-Marie Yaroslaski, S. Luedtke, Jennifer Super
{"title":"Probiotic Use in the NICU: What’s Taking So Long?","authors":"C. McPherson, Ann-Marie Yaroslaski, S. Luedtke, Jennifer Super","doi":"10.1177/1941406414549289","DOIUrl":"https://doi.org/10.1177/1941406414549289","url":null,"abstract":"","PeriodicalId":398639,"journal":{"name":"ICAN: Infant, Child, & Adolescent Nutrition","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122364449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-10-01DOI: 10.1177/1941406414543184
Michelle Johnson
A standardized approach to feeding offers numerous beneficial outcomes for low birth weight infants. Statistically significant outcomes for a decreased incidence of necrotizing enterocolitis (NEC) have been replicated across multiple studies. Studies with primary outcome measures of nutrition have found statistically significant improvements in days of parenteral nutrition, energy and protein intake from parenteral and enteral nutrition, days nil per os after feeds had been started, and days to achieve full enteral caloric feeds. Extremely low birth weight infants achieved 120 and 160 mL/kg per day significantly faster and with a significantly decreased incidence of NEC compared with controls. Additional studies with primary outcome measures of growth have found significantly lower days to return to birth weight, and significantly fewer infants discharged with weight <10th percentile. For infants born ≤29 weeks postmenstrual age, use of a standard approach to feeding resulted in significantly larger weigh...
{"title":"Outcomes Related to a Standardized Feeding Approach for Low Birth Weight Infants","authors":"Michelle Johnson","doi":"10.1177/1941406414543184","DOIUrl":"https://doi.org/10.1177/1941406414543184","url":null,"abstract":"A standardized approach to feeding offers numerous beneficial outcomes for low birth weight infants. Statistically significant outcomes for a decreased incidence of necrotizing enterocolitis (NEC) have been replicated across multiple studies. Studies with primary outcome measures of nutrition have found statistically significant improvements in days of parenteral nutrition, energy and protein intake from parenteral and enteral nutrition, days nil per os after feeds had been started, and days to achieve full enteral caloric feeds. Extremely low birth weight infants achieved 120 and 160 mL/kg per day significantly faster and with a significantly decreased incidence of NEC compared with controls. Additional studies with primary outcome measures of growth have found significantly lower days to return to birth weight, and significantly fewer infants discharged with weight <10th percentile. For infants born ≤29 weeks postmenstrual age, use of a standard approach to feeding resulted in significantly larger weigh...","PeriodicalId":398639,"journal":{"name":"ICAN: Infant, Child, & Adolescent Nutrition","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126361883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-09-22DOI: 10.1177/1941406414549622
S. Ramsay, A. Eskelsen, L. Branen, J. Shultz, J. Plumb
Children’s fruit and vegetable consumption (FVC) is below recommendations. Objectives of the study were to (a) describe the type and frequency of FVC, (b) analyze the average nutrient intake from young children’s fruit consumption and vegetable consumption separately, and (c) determine the contribution of demographic factors on FVC. Children aged 2 to 5 years (n = 821) were identified using the 2009-2010 National Health and Nutrition Examination Survey. Average servings and nutrient intake from FVC were estimated. Multiple comparisons among age, gender, body mass index (BMI), ethnicity, and poverty index ratio (PIR) were analyzed using an ANCOVA. Akaike’s information criterion determined relative contribution of each factor to FVC. Children consumed 3 times as many fruit servings as vegetable servings regardless of age, gender, BMI, ethnicity, and PIR. Potato products and fruit juice were consumed most frequently and in the greatest amounts. In general, children obtained more nutrients from fruits than ve...
{"title":"Nutrient Intake and Consumption of Fruit and Vegetables in Young Children","authors":"S. Ramsay, A. Eskelsen, L. Branen, J. Shultz, J. Plumb","doi":"10.1177/1941406414549622","DOIUrl":"https://doi.org/10.1177/1941406414549622","url":null,"abstract":"Children’s fruit and vegetable consumption (FVC) is below recommendations. Objectives of the study were to (a) describe the type and frequency of FVC, (b) analyze the average nutrient intake from young children’s fruit consumption and vegetable consumption separately, and (c) determine the contribution of demographic factors on FVC. Children aged 2 to 5 years (n = 821) were identified using the 2009-2010 National Health and Nutrition Examination Survey. Average servings and nutrient intake from FVC were estimated. Multiple comparisons among age, gender, body mass index (BMI), ethnicity, and poverty index ratio (PIR) were analyzed using an ANCOVA. Akaike’s information criterion determined relative contribution of each factor to FVC. Children consumed 3 times as many fruit servings as vegetable servings regardless of age, gender, BMI, ethnicity, and PIR. Potato products and fruit juice were consumed most frequently and in the greatest amounts. In general, children obtained more nutrients from fruits than ve...","PeriodicalId":398639,"journal":{"name":"ICAN: Infant, Child, & Adolescent Nutrition","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131331710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-08-01DOI: 10.1177/1941406414541677
L. Frank, J. Schall, Julia Samuel, B. Zemel, K. A. Dougherty, F. Tuluc, R. Rutstein, V. Stallings
Objective. To describe the dietary intake of HIV-infected urban children and young adults and to evaluate their diet quality. Methods. Participants were children and youth with both perinatally and behaviorally acquired HIV infection participating in a study of vitamin D supplementation. Data collected included dietary intake, anthropometrics, and HIV status, with medical history abstracted from participants’ medical records. Results. Of 55 participants, 38 were male, 46 were African American, with a mean age of 20.7 ± 3.8 years. Growth and nutritional status were comparable to reference norms. Only 22% either met or exceeded their estimated energy requirement at low-active and 40% at sedentary activity levels. Fiber, potassium, and intakes of vitamins D and E were <50% of recommended dietary allowance/adequate intake (RDA/AI), whereas vitamins A and K, choline, potassium, calcium, and magnesium were ≤75% of RDA/AI. Sodium intake exceeded the dietary reference intake upper limit in 92%. Vitamin D intake w...
{"title":"Dietary and Supplement Intake of HIV-Infected Children and Young Adults:","authors":"L. Frank, J. Schall, Julia Samuel, B. Zemel, K. A. Dougherty, F. Tuluc, R. Rutstein, V. Stallings","doi":"10.1177/1941406414541677","DOIUrl":"https://doi.org/10.1177/1941406414541677","url":null,"abstract":"Objective. To describe the dietary intake of HIV-infected urban children and young adults and to evaluate their diet quality. Methods. Participants were children and youth with both perinatally and behaviorally acquired HIV infection participating in a study of vitamin D supplementation. Data collected included dietary intake, anthropometrics, and HIV status, with medical history abstracted from participants’ medical records. Results. Of 55 participants, 38 were male, 46 were African American, with a mean age of 20.7 ± 3.8 years. Growth and nutritional status were comparable to reference norms. Only 22% either met or exceeded their estimated energy requirement at low-active and 40% at sedentary activity levels. Fiber, potassium, and intakes of vitamins D and E were <50% of recommended dietary allowance/adequate intake (RDA/AI), whereas vitamins A and K, choline, potassium, calcium, and magnesium were ≤75% of RDA/AI. Sodium intake exceeded the dietary reference intake upper limit in 92%. Vitamin D intake w...","PeriodicalId":398639,"journal":{"name":"ICAN: Infant, Child, & Adolescent Nutrition","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127837579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-08-01DOI: 10.1177/1941406414538496
C. Hanson, A. Anderson-Berry, Shelby Hoskins, E. Lyden, L. Bilek, T. Dolphens, K. Hartmann, M. J. Hawkins, C. Fernández
Background. Studies of vitamin D status have linked low 25(OH)D levels with biomarkers of cardiovascular disease and diabetes. Obese children and adolescents are at greater risk of vitamin D deficiency as vitamin D is thought to be sequestered in adipose tissue. The objective of this analysis was to examine the associations between 25(OH)D status and risk factors for cardiovascular disease and diabetes in a population of overweight and obese children enrolled in a medical management program. Materials and Methods. A retrospective chart review was conducted of 161 children enrolled in a medical weight management program. Pearson correlation coefficient were used to evaluate associations of biochemical measurements and 25(OH)D status. Multiple regression was used to evaluate 25(OH)D levels as a predictor of risk factors for cardiovascular disease and diabetes. Results. The mean body mass index (BMI) of the population was 34 kg/m2, mean 25(OH)D levels were 21.8 ng/mL. White subjects had significantly higher ...
{"title":"Vitamin D Status and Associations With Risk Factors for Cardiovascular Disease and Diabetes in Children Enrolled in a Medical Weight Management Program","authors":"C. Hanson, A. Anderson-Berry, Shelby Hoskins, E. Lyden, L. Bilek, T. Dolphens, K. Hartmann, M. J. Hawkins, C. Fernández","doi":"10.1177/1941406414538496","DOIUrl":"https://doi.org/10.1177/1941406414538496","url":null,"abstract":"Background. Studies of vitamin D status have linked low 25(OH)D levels with biomarkers of cardiovascular disease and diabetes. Obese children and adolescents are at greater risk of vitamin D deficiency as vitamin D is thought to be sequestered in adipose tissue. The objective of this analysis was to examine the associations between 25(OH)D status and risk factors for cardiovascular disease and diabetes in a population of overweight and obese children enrolled in a medical management program. Materials and Methods. A retrospective chart review was conducted of 161 children enrolled in a medical weight management program. Pearson correlation coefficient were used to evaluate associations of biochemical measurements and 25(OH)D status. Multiple regression was used to evaluate 25(OH)D levels as a predictor of risk factors for cardiovascular disease and diabetes. Results. The mean body mass index (BMI) of the population was 34 kg/m2, mean 25(OH)D levels were 21.8 ng/mL. White subjects had significantly higher ...","PeriodicalId":398639,"journal":{"name":"ICAN: Infant, Child, & Adolescent Nutrition","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128279947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-08-01DOI: 10.1177/1941406414540751
Christel Hyden, K. Bonuck
Serving cereal and other foods by baby bottle is a common infant feeding practice, yet little research explores how this practice may continue beyond the first year of life or following transition from the bottle to sippy cups. This article describes the addition of solids and sweeteners into bottles and sippy cups of milk, formula, or nondairy milk among children aged 1 to 2 years in an urban Women, Infants, and Children clinic. This observational study recruited n = 299 low-income nutrition program clients whose 12-month-olds consumed ≥2 nonwater bottles per day. Dietary recall data were extracted for the 3105 servings of milk, formula, or nondairy milk in bottles or sippy cups and analyzed for vessel, content, addition of solids or sweeteners (eg, cereals or syrups), calories, and added grams of sugar. Sixty-one percent of children had a solid or sweetener added to their beverage at least once. Solids or sweeteners were added to 38% of baby bottles and 21% of sippy cups. Presence of solids and sweetene...
{"title":"Addition of Solids and Sweeteners in Toddler Bottles and Sippy Cups","authors":"Christel Hyden, K. Bonuck","doi":"10.1177/1941406414540751","DOIUrl":"https://doi.org/10.1177/1941406414540751","url":null,"abstract":"Serving cereal and other foods by baby bottle is a common infant feeding practice, yet little research explores how this practice may continue beyond the first year of life or following transition from the bottle to sippy cups. This article describes the addition of solids and sweeteners into bottles and sippy cups of milk, formula, or nondairy milk among children aged 1 to 2 years in an urban Women, Infants, and Children clinic. This observational study recruited n = 299 low-income nutrition program clients whose 12-month-olds consumed ≥2 nonwater bottles per day. Dietary recall data were extracted for the 3105 servings of milk, formula, or nondairy milk in bottles or sippy cups and analyzed for vessel, content, addition of solids or sweeteners (eg, cereals or syrups), calories, and added grams of sugar. Sixty-one percent of children had a solid or sweetener added to their beverage at least once. Solids or sweeteners were added to 38% of baby bottles and 21% of sippy cups. Presence of solids and sweetene...","PeriodicalId":398639,"journal":{"name":"ICAN: Infant, Child, & Adolescent Nutrition","volume":"os-4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127758076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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