Mastodawn

I'm seeking advice and insights from others on the following issue:

How do you manage a four-week-old premature baby with evolving or established chronic lung disease (CLD) who is still on invasive ventilation or non-invasive ventilation (NIV) and requires a significant amount of FiO2 (>40%)?

The baby's weight gain has been poor, necessitating an increase in the total fluid intake (TFI) up to 180ml/kg/day of Mom Own Milk (MOM) and fortifiers, as well as the use of diuretics.

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NICU of Things May 6, 2023

In my experience, and based on most cases of CLD, these infants benefit from fluid restriction (<150ml/kg/day), which typically leads to a reduction in oxygen requirements. I usually supplement nutrition by adding preterm formula or high-energy formula to the TFI. However, I'm wondering if there are other ways to increase the nutritional value of (MOM+F) without using formula milk. adding Proteins?

Thanks,

#NICU99 #nicuverse #cld #bpd #Nutrient

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piatkat Jul 18, 2023

@NicuofThings I don't have the answer to your question, but I've just realized this year @99nicu had a webinar with prof Christoph Fusch about human milk analysis in the NICU. It was a great lecture, he presented many studies on MOM/ donor milk fortification, maybe you can get inspired there? https://youtu.be/5HwzXOJAntQ #neoEBM

Human milk analysis | Clinical decision support tools in the newborn nursery

YouTube

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NICU of Things Jul 18, 2023

@piatkat @99nicu thanks so much! In some units we used to give extra protein in addition to fortifiers . Do you do bedside mother milk analysis?

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Gustaf Lernfelt Jul 18, 2023

@NicuofThings @piatkat @99nicu In Sweden it’s routine to analyse the mothers milk, not every batch, but at least with a two week interval. At many NICU:s it’s registered in a very basic program called Nutrium together with fluids and fortifiers, which will help you balance micro-and macronutrients sufficiently. You can also follow growth through Z-score.