The Role of the Neonatal Registered Dietitian Nutritionist
Neonatal registered dietitian nutritionists (RDNs) are critical members of the neonatal intensive care unit (NICU) team due to their unique skillset of growth assessment, nutrition evaluation, and implementation of nutrition best practices. There is a paucity of data on appropriate staffing of neonatal RDNs in NICUs to promote improved patient outcomes. Here, the authors describe current neonatal RDN staffing and responsibilities in the US NICUs. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - June 2, 2023 Category: Perinatology & Neonatology Authors: Stephanie Merlino Barr, Rosa K. Hand, Tanis R. Fenton, Sharon Groh-Wargo Source Type: research
Parenteral Nutrition in the Neonatal Intensive Care Unit
This article reviews different ILEs and their constituents and their relationship with neonatal health. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - May 31, 2023 Category: Perinatology & Neonatology Authors: Alvin P. Chan, Sara Rostas, Samantha Rogers, Camilia R. Martin, Kara L. Calkins Source Type: research
Calcium and Phosphorus
Inadequate intake of calcium and phosphorus during the perinatal period can result in metabolic bone disease (MBD), characterized by decreased bone mass, altered bone mineralization, and increased risk for fractures. Preterm neonates have higher risk of developing MBD. Treating MBD involves ensuring adequate calcium and phosphorus intake, early fortification, and vitamin D supplementation. Health care providers should closely monitor nutrient intake, postnatal growth, and screening of preterm neonates at risk for MBD. This review summarizes the critical roles of calcium and phosphorus in regulating bone physiology, how the...
Source: Clinics in Perinatology - May 31, 2023 Category: Perinatology & Neonatology Authors: Katerina Kellar, Nisha Reddy Pandillapalli, Alvaro G. Moreira Source Type: research
Administering Parenteral Nutrition in the Neonatal Intensive Care Unit
Use of parenteral nutrition (PN) in the neonatal intensive care unit (NICU) requires evaluating the need for central venous catheters, potential drug incompatibilities, unintentional exposures, and suboptimal energy and nutrient intake during the transition to full enteral nutrition. Risks of photooxidation reactions in PN components, refeeding syndrome, and excess early amino acid intake should prompt the reevaluation of routine practices. The goal of this paper is to review the practicalities, challenges, and conundrums of administering PN in the NICU. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - May 26, 2023 Category: Perinatology & Neonatology Authors: Anne L. Smazal, Imran M. Ilahi, Janice Raucci, Daniel T. Robinson Source Type: research
The Practice of Enteral Nutrition
Establishing full enteral nutrition in critically ill preterm infants with immature gastrointestinal function is challenging. In this article, we will summarize emerging clinical evidence from randomized clinical trials suggesting the feasibility and efficacy of feeding interventions targeting the early establishment of full enteral nutrition. We will also examine trial outcomes of higher volume feedings after the establishment of full enteral nutrition. Only data from randomized clinical trials will be discussed extensively. Future opportunities for clinical research will also be presented. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - May 26, 2023 Category: Perinatology & Neonatology Authors: Ariel A. Salas, Colm P. Travers Source Type: research
Human Milk Fortification Strategies in the Neonatal Intensive Care Unit
Multicomponent fortification is the standard of care to support short-term growth in preterm infants receiving human milk. There is no consensus regarding the optimal timing, method, or products used to fortify human milk. Both bovine milk-based and human milk-based human milk fortifiers are safe options, though increased fortification and enrichment may be needed to achieve adequate growth. Additional studies are needed to evaluate newer fortifier products and fortification strategies. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - May 26, 2023 Category: Perinatology & Neonatology Authors: Ting Ting Fu, Brenda Poindexter Source Type: research
Current Practices, Challenges, and Recommendations in Enteral Nutrition After Necrotizing Enterocolitis
Necrotizing enterocolitis (NEC) is a neonatal disease with high mortality and morbidity. There is a lack of evidence-based recommendations on nutritional rehabilitation following NEC, and much of the current practice is guided by institutional policies and expert opinions. After a diagnosis of NEC, infants are exposed to an extended period of bowel rest and a prolonged course of antibiotics. Recognizing the patient characteristics that predict nutritional tolerance, early initiation of enteral nutrition, minimizing periods of bowel rest and antibiotic exposure, and standardization of dietary practices are the mainstay of p...
Source: Clinics in Perinatology - May 26, 2023 Category: Perinatology & Neonatology Authors: Elena Itriago, Kimberly Fernandez Trahan, Leonor Adriana Massieu, Parvesh M. Garg, Muralidhar H. Premkumar Source Type: research
Nutrition Management of High-Risk Neonates After Discharge
Nutrition management of the high-risk infant after hospital discharge is complicated by the infant ’s dysfunctional or immature oral feeding skills, nutritional deficits, and the family’s feeding plan. Although evidence is limited, available studies point to developing an individualized nutritional plan, which accounts for these factors; protects and prioritizes the family’s plan for breast feeding; and promotes an acceptable growth pattern. Further research is needed to identify the type and duration of posthospital discharge nutrition to optimize high-risk infant neurodevelopment and body composition. Attention to ...
Source: Clinics in Perinatology - May 26, 2023 Category: Perinatology & Neonatology Authors: Shruti Gupta, Sarah N. Taylor Source Type: research
Common Quality Improvement Methodologies Including the Model for Improvement, Lean, and Six Sigma
This article reviews several common quality improvement methodologies, including the Model for Improvement, Lean, and Six Sigma. We demonstrate how these methods are based on a similar improvement science foundation. We describe the tools used to understand problems in the context of systems and the mechanisms to learn and build knowledge, using specific examples from the neonatology and pediatric literature. We conclude with a discussion on the importance of the human side of change in quality improvement, including team formation and culture. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - May 17, 2023 Category: Perinatology & Neonatology Authors: Katherine Coughlin, Michael A. Posencheg Source Type: research
CME Accreditation Page
(Source: Clinics in Perinatology)
Source: Clinics in Perinatology - May 17, 2023 Category: Perinatology & Neonatology Source Type: research
Quality Improvement
CLINICS IN PERINATOLOGY (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - May 17, 2023 Category: Perinatology & Neonatology Authors: HEATHER C. KAPLAN, MUNISH GUPTA Source Type: research
Copyright
ELSEVIER (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - May 17, 2023 Category: Perinatology & Neonatology Source Type: research
Contributors
LUCKY JAIN, MD, MBA (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - May 17, 2023 Category: Perinatology & Neonatology Source Type: research
Contents
Lucky Jain (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - May 17, 2023 Category: Perinatology & Neonatology Source Type: research
Forthcoming Issues
Neonatal Nutrition: Evidence-Based Recommendations for Common Problems (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - May 17, 2023 Category: Perinatology & Neonatology Source Type: research
