Two neos chat: How do we advance feeds in the NICU??

Lots of feeding QUESTIONS for NEONATES especially PREMATURE infants!!// Q2, Q3 or Q4 hour feeds? What are TROPHIC feeds? Fortification? How do we advance? Donor breast milk? Do we use formula? When do we fortify? Do we care about residuals? We discuss the different ways we practice in our units and our common concerns (NEC, poor growth, poor gut development, poor developmental outcomes, prolonged TPN use and need for IV access). Join our discussion, and let us know what you do in YOUR unit?!!!
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Dr. Tala is a board-certified neonatologist and has worked in busy level III and IV units for the past 15 years. She has won multiple teaching awards throughout her time as a neonatologist.
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References:
Jasani B, Patole S. Standardized feeding regimen for reducing necrotizing enterocolitis in preterm infants: an updated systematic review. J Perinatol. 2017 Jul;37(7):827-833. doi: 10.1038/jp.2017.37. Epub 2017 Mar 30. PMID: 28358382.

Anderson DM, Kliegman RM. The relationship of neonatal alimentation practices to the occurrence of endemic necrotizing enterocolitis. Am J Perinatol. 1991 Jan;8(1):62-7. doi: 10.1055/s-2007-999344. PMID: 1899016.

Stevens TP, Shields E, Campbell D, Combs A, Horgan M, La Gamma EF, Xiong K, Kacica M. Variation in Enteral Feeding Practices and Growth Outcomes among Very Premature Infants: A Report from the New York State Perinatal Quality Collaborative. Am J Perinatol. 2016 Jan;33(1):9-19. doi: 10.1055/s-0035-1554794. Epub 2015 Jun 17. PMID: 26084749.


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