Benefits of early aggressive parenteral nutrition for growth of babies with low birth weight

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Baby nutrition illustration. (Source: May Baby)

Nowadays , stunting has become a global issue. Chronic malnutrition affects the child’s growth and development later in life. Poor intelligence will impact career problems and future success. Worse yet, stunting parent will tend to give birth to stunting children as well. Low birth weight babies and premature births are suspected to be a significant risk factor for stunting. Moreover, inadequate nutrition at birth will cause the baby to experience extrauterine growth retardation which will worsen the condition of malnutrition in low birth weight babies. For this reason, various efforts have been made by researchers in order to achieve extrauterine growth equivalent to intra-uterine growth.

Early aggressive parenteral nutrition has shown its benefits in preventing the inhibition of extra-uterine growth. However, in real practice, doctors remain in doubt to apply it to newborns and there are various obstacles in its administration because it requires access to large blood vessels and risks an infection. For this reason, a research was conducted at Dr Soetomo Regional Hospital as a national referral hospital for eastern Indonesia. This study aims to analyze the nutritional benefits provided by Early aggressive parenteral nutrition on the pattern of weight gain in premature infants.

This study compares the effects of aggressive nutrition through infusion with gradual increase. Researchers observed the speed of gaining weight velocity (GWV) and the time of recovery of the baby’s weight to birth weight (return to birthweight / RTBW). The study was conducted on 44 premature infants with gestational age less than 33 6/7 weeks, the birth weight of babies studied was around 1000-2500 grams and unable to receive daily nutritional needs through their mouth. The results of this study showed that the average RTBW was almost the same between the two groups.

The group that received aggressive nutrition actually had a higher weight loss on day 1 and day 3 and did not have a difference in weight loss on day 7, day 10, and day 14 compared to the nutrition that was increased gradually. It is possible that daily weight monitoring patterns will only provide a representation of fluid and electrolyte balance and do not reflect actual growth.

Both groups had faster weight gain rates on days 1 and 3 but were similar on day 14 (18 grams / kg / day and 16 grams / kg / day respectively). So we concluded that aggressive nutrition through early infusion does not have a significant effect on growth patterns of low birth weight infants at baseline. Further research needs to be carried out on the impact of aggressive nutrition on long-term growth patterns and the development of premature infant intelligence.

Author: Mahendra Tri Arif Sampurna

Link:

https://doi.org/10.34302/crpjfst/2019.11.5.15

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