Adjustable feedings plus accurate serial length measurements decrease discharge weight-length disproportion in very preterm infants

quality improvement project

Luc P Brion, Charles R Rosenfeld, Roy J Heyne, Steven L. Brown, Cheryl S. Lair, Patti J. Burchfield, Maria Caraig

Research output: Contribution to journalArticle

Abstract

Background: Preterm very-low-birth-weight (≤1500 g) infants exhibit disproportionate weight-for-length growth in the Neonatal Intensive Care Unit. Local problem: High frequency of body mass index (BMI) > 90th centile at discharge and 1-year postnatal age associated with elevated blood pressure and serum leptin in infancy and adolescence. Methods: Single-institution quality improvement project in appropriately grown infants born at 230/7–286/7 weeks gestational age and discharged home. Intervention: Adjustable feeding protocol based on valid serial length measurements (board or caliper). Results: The average monthly percentage of weight-for-length disproportion at discharge decreased from 13% in Epoch 1 to 0% in Epoch 2 (P < 0.05). Although the average Z-score for BMI at discharge was lower in Epoch 2 versus Epoch 1 (P < 0.01), this was absent by 1 year follow-up (P = 0.91). Conclusions: Adjustable feedings plus use of accurate serial length measurements decreases weight-for-length disproportion at hospital discharge but not at 1 year.

Original languageEnglish (US)
JournalJournal of Perinatology
DOIs
StatePublished - Jan 1 2019

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Quality Improvement
Premature Infants
Weights and Measures
Body Mass Index
Very Low Birth Weight Infant
Neonatal Intensive Care Units
Leptin
Gestational Age
Blood Pressure
Growth
Serum

ASJC Scopus subject areas

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

Cite this

@article{b0de26b6369046b7bf9ee0b46e1438c8,
title = "Adjustable feedings plus accurate serial length measurements decrease discharge weight-length disproportion in very preterm infants: quality improvement project",
abstract = "Background: Preterm very-low-birth-weight (≤1500 g) infants exhibit disproportionate weight-for-length growth in the Neonatal Intensive Care Unit. Local problem: High frequency of body mass index (BMI) > 90th centile at discharge and 1-year postnatal age associated with elevated blood pressure and serum leptin in infancy and adolescence. Methods: Single-institution quality improvement project in appropriately grown infants born at 230/7–286/7 weeks gestational age and discharged home. Intervention: Adjustable feeding protocol based on valid serial length measurements (board or caliper). Results: The average monthly percentage of weight-for-length disproportion at discharge decreased from 13{\%} in Epoch 1 to 0{\%} in Epoch 2 (P < 0.05). Although the average Z-score for BMI at discharge was lower in Epoch 2 versus Epoch 1 (P < 0.01), this was absent by 1 year follow-up (P = 0.91). Conclusions: Adjustable feedings plus use of accurate serial length measurements decreases weight-for-length disproportion at hospital discharge but not at 1 year.",
author = "Brion, {Luc P} and Rosenfeld, {Charles R} and Heyne, {Roy J} and Brown, {Steven L.} and Lair, {Cheryl S.} and Burchfield, {Patti J.} and Maria Caraig",
year = "2019",
month = "1",
day = "1",
doi = "10.1038/s41372-019-0424-8",
language = "English (US)",
journal = "Journal of Perinatology",
issn = "0743-8346",
publisher = "Nature Publishing Group",

}

TY - JOUR

T1 - Adjustable feedings plus accurate serial length measurements decrease discharge weight-length disproportion in very preterm infants

T2 - quality improvement project

AU - Brion, Luc P

AU - Rosenfeld, Charles R

AU - Heyne, Roy J

AU - Brown, Steven L.

AU - Lair, Cheryl S.

AU - Burchfield, Patti J.

AU - Caraig, Maria

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Preterm very-low-birth-weight (≤1500 g) infants exhibit disproportionate weight-for-length growth in the Neonatal Intensive Care Unit. Local problem: High frequency of body mass index (BMI) > 90th centile at discharge and 1-year postnatal age associated with elevated blood pressure and serum leptin in infancy and adolescence. Methods: Single-institution quality improvement project in appropriately grown infants born at 230/7–286/7 weeks gestational age and discharged home. Intervention: Adjustable feeding protocol based on valid serial length measurements (board or caliper). Results: The average monthly percentage of weight-for-length disproportion at discharge decreased from 13% in Epoch 1 to 0% in Epoch 2 (P < 0.05). Although the average Z-score for BMI at discharge was lower in Epoch 2 versus Epoch 1 (P < 0.01), this was absent by 1 year follow-up (P = 0.91). Conclusions: Adjustable feedings plus use of accurate serial length measurements decreases weight-for-length disproportion at hospital discharge but not at 1 year.

AB - Background: Preterm very-low-birth-weight (≤1500 g) infants exhibit disproportionate weight-for-length growth in the Neonatal Intensive Care Unit. Local problem: High frequency of body mass index (BMI) > 90th centile at discharge and 1-year postnatal age associated with elevated blood pressure and serum leptin in infancy and adolescence. Methods: Single-institution quality improvement project in appropriately grown infants born at 230/7–286/7 weeks gestational age and discharged home. Intervention: Adjustable feeding protocol based on valid serial length measurements (board or caliper). Results: The average monthly percentage of weight-for-length disproportion at discharge decreased from 13% in Epoch 1 to 0% in Epoch 2 (P < 0.05). Although the average Z-score for BMI at discharge was lower in Epoch 2 versus Epoch 1 (P < 0.01), this was absent by 1 year follow-up (P = 0.91). Conclusions: Adjustable feedings plus use of accurate serial length measurements decreases weight-for-length disproportion at hospital discharge but not at 1 year.

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