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Enteral Administration of a Simulated Amniotic Fluid to Very Low Birth Weight Neonates

Journal of Perinatology volume 25, pages 380–385 (2005)Cite this article

Abstract

OBJECTIVE:

To reduce feeding intolerance among very low birth weight neonates.

STUDY DESIGN:

A total of 10 neonates with birth weights of 750 to 1250 g were given oral-gastric boluses (2.5 ml/kg every 3 hours) of a solution patterned after amniotic fluid. When milk feedings were begun the milk was mixed with the test solution. The solution was given at a constant daily dose of 20 ml/kg/day while the volumes of milk feedings were gradually increased. When milk feedings reached 80 ml/kg/day the test solution was discontinued. A comparison group consisted of neonates who met study criteria but were cared for during the period immediately preceding the study. The outcome was the number of calories taken enterally over the first 21 days of life.

RESULTS:

The test solution was begun an average of 27 hours after birth (range, 4 to 45). In the test group the first milk feedings were introduced 74 hours after birth (range, 18 to 144), which was similar to the time milk was introduced in the comparison subjects (79 hours; range, 18 to 168). After milk feedings were started, the test patients had a total of four NPO days (0.4 NPO days per patient) during their first 21 days, while the comparison group had 34 NPO days (3.4 NPO days per patient). During the first 14 days of life the test solution recipients had a median of 26.5 enteral cal/kg/day (range, 4.3 to 68.9), while the comparison neonates had 8.5 (range, 0.2 to 25; p<0.05). During the first 21 days of life the test solution recipients had a median of 56.9 enteral cal/kg/day (range, 11.5 to 89.4), while the comparison neonates had 19.2 (range, 0.9 to 52.8; p<0.05).

CONCLUSION:

In all, 10 VLBW infants tolerated the test solution for periods up to 14 days with no significant adverse effects. A randomized trial to determine whether this solution reduces feeding intolerance among VLBW neonates should be conducted.

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Acknowledgements

We thank Jon T. Horn, RPH, research pharmacist at McKay Dee Hospital Center, Ogden, UT for his valuable assistance with the study. We also thank Dr. David Auerbach, Medical Director of the NICU at Arnold Palmer Hospital for Women and Children, Orlando, Florida, for serving as Chair of the Data Safety and Monitoring Board, and Dawn Bruton, Debra Patrick, Susan Stripling, and Brenda Smith for research nursing assistance. We also thank the NICU nursing staff at Intermountain Health Care and Tampa General Hospital for their assistance, and the staff at the US Food and Drug Administration for their helpful suggestions regarding the study design.

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Authors and Affiliations

  1. The Intermountain Health Care Neonatology Collaborative Research Group, Ogden, UT, USA

    Robert D Christensen MD & Dale R Gerstmann MD

  2. University of South Florida College of Medicine, Tampa, FL, USA

    Thomas Havranek MD & Darlene A Calhoun DO

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  1. Robert D Christensen MD
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  2. Thomas Havranek MD
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  3. Dale R Gerstmann MD
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  4. Darlene A Calhoun DO
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Christensen, R., Havranek, T., Gerstmann, D. et al. Enteral Administration of a Simulated Amniotic Fluid to Very Low Birth Weight Neonates. J Perinatol 25, 380–385 (2005). https://doi.org/10.1038/sj.jp.7211306

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