A Nutritional Bundle Approach to Improve Growth Outcomes in Very Low Birth Weight Infants

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Topic(s): Nutrition Health & Wellness Obesity Nutrition & Disease Management

Effect of Nutritional Bundle Intervention on Growth Outcomes in Very Low Birth Weight Infants

Postnatal malnutrition is a problem in very low birth weight (VLBW) preterm infants. Some of the suggested interventions to improve growth outcomes in VLBW infants include Kangaroo care; early and aggressive enteral and parenteral nutrition; milk fortification; and post-discharge formulae. A study published in The Journal of Maternal-Fetal & Neonatal Medicine assessed the effect of a nutrition bundle approach including these interventions to reduce postnatal malnutrition in exclusively breastfed infants.

A total of 389 infants weighing less than 1500 g and gestation age of less than 37 weeks were enrolled. Infants born between January 2008 to December 2009 were in the before nutritional bundle intervention (BNB) period and infants born between November 2011 to March 2013 were in the after nutritional bundle intervention (ANB) period. Nutrition bundle approach consisted of introducing amino acids within hours of birth, introducing 3 g of lipids/kg/day and 3 g of amino acids/kg/day on day two and fortification of human milk. Malnutrition at term corrected gestational age was the primary outcome of the study.

The incidence of malnutrition was similar during BNB and ANB periods. At discharge, infants in ANB period had a higher mean weight and length compared to those born in the BNB period. Weight gain and head size were similar in both the groups. At term corrected age, infants in the ANB period were taller compared to those born in BNB period. Early introduction of amino acids and total parenteral nutrition improved weight and length of the infants at discharge. An increase in length and head size of the infants was observed as a result of total parenteral nutrition.

Nutritional bundle approach improved length and weight of the infants at discharge from the hospital and the length at term gestational age. However, it did not affect the incidence of malnutrition at term gestational age in VLBW preterm infants.

News source - Khanam S, Khan J, Sharma D, et al. Nutritional bundle to improve growth outcomes among very low birth weight infants. J Matern Fetal Neonatal Med. 015; 28(15):1851-5.