Implementation of feeding guidelines in infants at risk of intestinal failure

D. R. Shores, J. E. Bullard, S. W. Aucott, F. D. Stewart, C. Haney, H. Tymann, M. R. Miller, B. A.S. Nonyane, K. B. Schwarz

Research output: Contribution to journalArticlepeer-review


Objective:To implement feeding guidelines to reduce advancement time and the incidence of parenteral nutrition-associated liver disease (PNALD) among intestinal surgical infants requiring parenteral nutrition (PN).Study Design:Feeding guidelines with higher initial enteral nutrition (EN) volume and specific advancement criteria were implemented for surgical infants aged <6 months. Preimplementation and postimplementation outcomes were compared.Results:There were 57 preimplementation and 33 postimplementation infants. The initial EN volume improved from 10 to 20 ml kg -1 day -1 (P<0.001). Time to reach 50% of goal calories from EN decreased by a median of 6 days (P=0.012) without a change in necrotizing enterocolitis incidence after resuming feeding. PNALD incidence decreased from 70% to 48% (P=0.046), and median peak direct bilirubin (DB) decreased from 5.6 to 2.3 mg dl -1 (P=0.011).Conclusion:Feeding guideline implementation with higher initial feeding volume was well tolerated and resulted in faster achievement of 50% goal EN calories. PNALD incidence and peak DB were reduced.

Original languageEnglish (US)
Pages (from-to)941-948
Number of pages8
JournalJournal of Perinatology
Issue number11
StatePublished - Nov 1 2015

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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