MedUni Vienna: New nutritional strategy gives a boost to tiny premature babies

On New Year's Day this coming Sunday, we will once again be waiting to see whereabouts in Austria the first baby is born safe and sound to be our "New Year's Baby 2017". It could even be a premature baby. The tiniest premature babies – weighing less than 1 kg at birth – often fail to gain very much weight during their long stay in hospital and this impacts upon their subsequent growth. Now, however, a retrospective data analysis conducted at MedUni Vienna’s Department of Pediatrics and Adolescent Medicine has shown that "more aggressive" nutrition, especially including more protein, brings about a significant improvement in the nutritional status, development and growth of these tiny infants.

"Previously we have been extremely careful with the feeding of these tiny premature babies, for fear of causing enteritis," explains Andreas Repa of the Department of Pediatrics and Adolescent Medicine at MedUni Vienna/Vienna General Hospital. "However, our data analysis shows that a new, strategy, based on recent international studies, is much more successful."

"New" means: the babies are primarily given more protein, as well as vitamins, electrolytes, calcium and sugar, via a tube and by intravenous drip. This helps to make up for the nutritional deficit that these premature babies have, because they were delivered before the 28th week of gestation and at a low birth weight of around d 1 kg. If they had gone to term, they would have received these nutrients via their mother's placenta as the pregnancy progressed.

The outcome of the data analysis: infants fed in this way weighed more at the time of their subsequent discharge from hospital (around 2.5 kg as opposed to the average 2 kg with conventional nutrition) and they had gained a centimetre more in head circumference and height than other premature babies, who had been conventionally fed. Says Repa: "This shows that the change in best practice is proving to be very successful. These tiny premature babies leave hospital in a more robust state and end up being not much smaller than other children."

This new strategy is yet another building block in the highly successful premature baby care offered at MedUni Vienna and in Vienna General Hospital. Every year, these facilities care for around 200 infants born before the 32nd week of gestation – 100 of these being born between weeks 23 and 27, that is to say as much as 17 weeks premature.

Comparative figures show that the survival rates for these very premature babies born on the neonatology wards of MedUni Vienna/Vienna General Hospital are the best in the world. At Vienna hospital, 70% of premature babies born in the 23rd or 24th week of pregnancy – which is currently regarded as the limit for viability – survive, in contrast to about 50 percent in international comparison.
Service: PeerJ
„Aggressive nutrition in extremely low birth weight infants: impact on parenteral nutrition associated cholestasis and growth.“ Andreas Repa, Ruth Lochmann, Lukas Unterasinger, Michael Weber, Angelika Berger, Nadja Haiden.

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