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  • Original Article
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Prevention of postnatal growth restriction by the implementation of an evidence-based premature infant feeding bundle

Journal of Perinatology volume 35, pages 642–649 (2015)Cite this article

Subjects

Abstract

Objective:

To develop an evidence-based feeding bundle to safely decrease the rate of PNGR in VLBW infants.

Study Design:

The bundle was developed and implemented in January 2010, followed by 3 years of monitoring bundle compliance and infant outcomes (days to first feed (FD), days to reach full feeds (FF), and birth-discharge growth trajectories (delta z-score)).

Results:

Data were collected on 482 infants (119 pre-bundle). PNGR decreased from 35% to 19% (P<0.01) and weight delta z-score improved from −0.82 to –0.45 (P<0.001). Percentage of infants with head circumference (HC) below 10th percentile at discharge decreased from 21% to 9% (P<0.01) and HC delta z-score improved from −0.65 to –0.17 (P<0.001). FD and FF also decreased significantly. Rates of necrotizing enterocolitis, peak alkaline phosphatase and peak direct bilirubin levels all trended downward.

Conclusions:

An evidence-based, standardized feeding bundle was safe and effective in reducing the rate of PNGR and in improving head growth in VLBW infants.

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Acknowledgements

The authors thank the neonatologists, neonatal nurse practitioners, physician assistants, NICU fellows, NICU nurses and the dietary staff at Albany Medical Center Hospital for their assistance and support in the development, implementation and compliance with the feeding bundle.

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Authors and Affiliations

  1. Nursing (Neonatology), Albany Medical Center, Albany, NY, USA

    P D Graziano

  2. Pediatrics (Neonatology), Children’s Hospital at Albany Medical Center, Albany, NY, USA

    K A Tauber, J Cummings & M J Horgan

  3. Epidemiology, Albany Medical Center, Albany, NY, USA

    E Graffunder

Authors
  1. P D Graziano
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  2. K A Tauber
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  3. J Cummings
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  4. E Graffunder
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  5. M J Horgan
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Corresponding author

Correspondence to P D Graziano.

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The authors declare no conflict of interest

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Supplementary Information accompanies the paper on the Journal of Perinatology website

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Graziano, P., Tauber, K., Cummings, J. et al. Prevention of postnatal growth restriction by the implementation of an evidence-based premature infant feeding bundle. J Perinatol 35, 642–649 (2015). https://doi.org/10.1038/jp.2015.35

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