Nutrition ✅ Flashcards
Is human breastmilk the optimal form of nutrition for extremely pre-term babies?
Yes
What are the advantages of breastmilk in extremely pre-term babies?
- GI tolerance better
- Reduces risk of necrotising enterocolitis
- Reduces risk of systemic infection
- Help prime bacterial colonisation of gut
What is often a problem when breastfeeding extremely pre-term babies?
Lack of success in producing sufficient breast milk
What can aggravate the lack of success in producing breast milk with extremely pre-term babies?
- Physical separation of mother and baby
- Difficulty in maintaining milk supply over long period
- Lack of motivation
- Inadequate support
What can improve the volume and duration of breastfeeding in extremely pre-term babies?
- Frequent expression
- Kangaroo care or skin to skin contact
- Relaxation tapes
What can improve production of breast milk?
- Breast pumping
- Massage prior to pumping
- Dopamine antagonists
What is increasingly being used when mother’s milk is not available?
Expressed donor milk
What happens to expressed donor milk before being given to the baby?
It is pooled and pasteurised
What can be given if breastmilk or expressed donor milk are not available?
Preterm infant formula
How does preterm infant formula differ from standard formula?
It has been modified to meet the increased nutrient requirements of extremely preterm infants
What does the use of a special formula for preterm infants result in?
- Faster weight, length, and head circumference growth
- Reduced incidence of hyponatraemia
- Reduced incidence of bone disease of prematurity
- Reduced incidence of hypophosphataemia
- Reduced incidence of hyperbilirubinaemia
What is the disadvantage of using infant formula in extremely preterm babies?
- Poorer tolerance of feeds
- Risk of NEC is increased
What is widely used to supplement expressed breast milk in extremely pre-term infants?
Human milk fortifiers containing protein, energy, macrominerals, trace minerals, and a range of vitamins
What is the advantage of human milk fortifiers?
They provide short-term improvements in weight gain, linear and head growth
What are the limitations of human milk fortifiers?
Evidence is lacking for long-term benefits
What are human milk fortifiers based on?
Cow’s milk
What is the result of human milk fortifiers being based on cow’s milk?
Their precise biological properties differ from that of human milk
What has more recently been used as a human milk fortifier?
‘Humanised’ milk fortifier
What is humanised milk fortifier based on?
Pooled donor breast milk
What is the advantage of humanised milk fortifier?
Lower risk of NEC compared to preparations based on cow’s milk
When is parenteral nutrition required in pre-term babies?
If adequate enteral feeding is not possible
Why is parenteral nutrition often required in pre-term babies?
Extremely preterm infants have very limited ability to withstand starvation due to their low protein, fat, and carbohydrate stores
