Abstract 1494

Nutritional management of VLBW infants in the NICU at the University Hospital in Buenos Aires includes early introduction of total parenteral nutrition (TPN) with lipids, delivering an average of 90 kcal/kg/day. Oral feeds are introduced as soon as possible, depending on tolerance. Volume of feeds is: slowly increased accompanied by a parallel decrease in TPN volume. Final calories on oral feeds are: 120 kcal/kg. Growth on TPN in VLBW infants is slow compared to intrauterine standards. Recent evidence in the literature has shown that this slow growth is also present when infants receive TPN plus oral feeds. The present paper was designed to establish pre and post-discharge growth in our population of VLBW infants managed with TPN as sole source of calories for more than 7 days, and discharged home on full enteral feeds. For each infant weekly weight (W), length (L) and head circumference (HC) were determined and plotted against growth chart, and the percentile established according to postconceptional age (PCA) until discharge. W, L and HC were measured by the follow-up team at 1, 3, 6, 9 and 12 months postdischarge, adjusted for PCA and plotted against national growth charts. Of the 23 infants studied between 6/1/95 and 6/30/97 (BW 1030 g; GA 30 wks), two died in hospital and four were lost to follow up. (SD=standard deviation; CA= corrected age) (Table) These data show that all VLBW infants in our population gain W at or below 2 SD. This W deficit persists throughout the first 12 months of life (up to 9 months CA). Growth in L tends to show improvement and HC is spared. We conclude that the discordance in W vs L and HC is indicating perhaps less fat deposition but adequate structural growth. The impact of delayed growth in this population still needs to be assessed.

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