NICU of ThingsMay 6, 2023

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.

Show threadNICU of Things

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

May 6, 2023 at 1:40pmWeb
Show threadpiatkatJul 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
Show threadNICU of ThingsJul 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?
Show threadGustaf LernfeltJul 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.