Nutritional Strategies for the Very Low Birthweight Infant

by David H. Adamkin MD

Overview

The goal of nutritional management in VLBW and ELBW infants is the achievement of postnatal growth at a rate that approximates the intrauterine growth of a normal fetus at the same postconceptional age. In reality, however, growth lags considerably after birth; although non-nutritional factors are involved, nutrient deficiencies are critical in explaining delayed growth. This practical clinically-oriented pocketbook reviews and summarises all available clinical evidence. It enables the reader to implement parenteral or enteral feeding plans, with the goals of reducing postnatal weight loss, earlier return to birthweight, and improved catch-up growth. Both nutrient balance and growth and the impact on neurodevelopment and health outcomes are evaluated. With many tables and algorithms to summarise key data and management strategies, Nutritional Strategies for the Very Low Birthweight Infant is an invaluable guide for all healthcare professionals caring for premature babies.

Product Details

ISBN-13:	9781139813983
Publisher:	Cambridge University Press
Publication date:	08/27/2009
Sold by:	Barnes & Noble
Format:	eBook
File size:	1 MB

About the Author

David H. Adamkin is Professor of Pediatrics and Director of the Division of Neonatal Medicine, University of Louisville, Louisville, Kentucky, USA.

Table of Contents

Dedication; Acknowledgements; Foreword; Glossary; 1. Introduction; 2. Fluid and electrolytes management (Na, Cl and K); 3. Energy; 4. Intravenous carbohydrates; 5. Intravenous lipids; 6. Early total parenteral nutrition (TPN); 7. Parenteral calcium, phosphorous, magnesium and Vitamin D; 8. Parenteral vitamins; 9. Trace elements and iron; 10. Parenteral nutrition guide; 11. Parenteral nutrition-associated cholestasis in VLBW infants; 12. Enteral nutrition; 13. Enteral feeding guidelines pPracticum; 14. Optimizing enteral nutrition: protein; 15. Human milk; 16. Premature infant formulas; 17. Standard infant formulas; 18. Soya formulas; 19. Protein hydrolysate formulas; 20. Enteral calcium, phosphorus, magnesium and Vitamin D; 21. Iron; 22. Hypercaloric feeding strategy; 23. Growth in the neonatal intensive care unit influences neurodevelopmental and growth outcomes; 24. Nutritional assessment; 25. Post discharge strategies; 26. Nutritional management of preterm infants with short bowel syndrome; 27. Summary; Index.

Editorial Reviews

Reviewer: Jay P. Goldsmith, MD (Tulane University School of Medicine)
Description: This easy to read, practical book reviews evidence-based nutritional strategies for the very low birthweight infant. The book deals with everyday issues faced by healthcare providers in the modern neonatal intensive care unit. It is clinically oriented with tables of practical tips in each chapter to help guide clinicians in the nutritional care of these very fragile infants.
Purpose: According to the author, the book provides a "clinical practicum to implement parenteral and enteral feeding guidelines" in very low birthweight infants. The author takes a very aggressive approach to nutrition to prevent postnatal weight loss and undernutrition which may have significant short-term and long-term consequences in this population. These are indeed worthy objectives that are well met in this monograph.
Audience: The book is aimed at all clinical providers in the neonatal intensive care unit. Written in a practical, easy-to-read, and understandable style, it can be used by medical students, residents, nurses, nutritionists, nurse practitioners, and physicians. It may be too simplistic for the very sophisticated gastroenterologist, but despite the simplicity, the recommended evidence-based guidelines are often not followed in many units throughout this country. The author and his reviewers are noted authorities in this area of medicine.
Features: The 27 relatively short chapters discuss normal intrauterine and extrauterine growth, energy, the basic components of nutrition (carbohydrate, protein, and fat), vitamins, minerals, and trace elements. Other chapters cover human milk, formulas, strategies for feeding, and nutritional assessment. Tables are included when appropriate and each chapter concludes with a table of practical tips. I especially enjoyed the introductory chapter on enteral nutrition and the concept of NECiphobia (fear of necrotizing enterocolitis).
Assessment: This is a wonderful contribution to the practical literature on neonatal nutritional care. It highlights the important contribution of optimal nutrition to the prevention of long-term neurodevelopmental and health sequelae as consequences of severe prematurity. Hopefully, Dr. Adamkin's recommendations regarding nutritional management of this very vulnerable population will find general acceptance in our NICUs.

Doody's Review Service

"This easy to read, practical book reviews evidence-based nutritional strategies for the very low birthweight infant....[A] wonderful contribution to the practical literature on neonatal nutritional care."
—Doody's Review Service

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