Implementation of a Nutrition Care Bundle and Improved Weight Gain of Extremely Preterm Infants to 36 Weeks Postmenstrual Age

• Published in: The Journal of pediatrics 2022-02, Vol.241, p.42-47.e2
• Main Authors: McKinley, Leslie T., Przystac, Lynn, Tucker, Richard, Trail-Burns, Elizabeth, Vohr, Betty R., Laptook, Abbot R., Bliss, Joseph M.
• Format: Article
• Language: English
• Subjects: Birth Weight; Child; extrauterine growth restriction; Female; Gestational Age; Humans; Infant; Infant, Extremely Low Birth Weight; Infant, Extremely Premature; Infant, Newborn; Patient Care Bundles; Pregnancy; Premature Birth; prematurity; protein; Retrospective Studies; Weight Gain
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2021.10.016

To evaluate the effect of a nutrition care bundle in improving growth in premature infants during neonatal hospitalization. This study was a retrospective analysis of prospectively collected data for 584 surviving infants with birth weight ≤1000 g and gestational age 24-29 weeks admitted to a single-center neonatal intensive care unit between July 3, 2005, and June 6, 2016. Participants were divided into 3 discrete epochs based on evolving nutrition practices during the study period: epoch 1, baseline, open-bay setting; epoch 2, improved lactation staffing, introduction of high-protein formula, single-family room setting; epoch 3, complete nutrition care bundle. Infants in each epoch were evaluated for the primary outcome of change in weight z-score between postnatal day 7 and 36 weeks postmenstrual age (PMA) or discharge if sooner. Univariate and multivariable regression analyses were conducted to evaluate the effect of clinical variables on outcome. Significant increases in weight z-score between day of life 7 and 36 weeks PMA were observed across the 3 epochs, which accounted for 31% (P