Burnham Laura A, Lopera Adriana M, Mao Wenyang, McMahon Marcy, Philipp Barbara L, Parker Margaret G
Department of Pediatrics, Boston Medical Center and Boston University School of Medicine, Boston, Massachusetts; and.
Department of Neonatology, Beth Israel Deaconess Medical Center and Harvard Medical School, Harvard University, Boston, Massachusetts.
Hosp Pediatr. 2018 Aug;8(8):486-493. doi: 10.1542/hpeds.2017-0206. Epub 2018 Jul 13.
Late preterm (LPT) infants are at risk for feeding difficulties. Our objectives were to reduce the use of intravenous (IV) fluids and increase breastfeeding at discharge among LPT infants admitted to our NICU.
We implemented a feeding guideline and evaluated its effect using a pre-post design. We examined rates of our main outcomes, IV fluid use, and any or exclusive breastfeeding at discharge, as well as several secondary outcomes, including hypoglycemia (glucose <50 mg/dL) at >8 hours of life, by using χ and tests. We excluded infants that were <2000 g, admitted to the NICU at >8 hours of life, or needed IV fluids at ≤8 hours of life for a medical reason. We used multivariable logistic regression to examine odds ratios and 95% confidence intervals of our main outcomes.
Fifty percent of infants were eligible. Of those eligible, 18 of 52 (35%) vs 14 of 65 (22%) received IV fluids at >8 hours of life ( = .06). In the 24 hours before discharge, 35 of 52 (75%) vs 46 of 65 (78%) received any breast milk ( = .67), and 10 of 52 (30%) vs 10 of 65 (21%) received exclusive breast milk ( = .43). More infants had hypoglycemia in the posttime period (16 of 65 [25%]) compared with the pretime period (3 of 52 [6%]; = .01).
After implementation of a LPT feeding guideline in our NICU that defined specific expected feeding volumes, we did not find changes in IV fluid use or breastfeeding.
