Parenteral nutrition in the newborn
Every year in the country 45 thousand children are born before the 37th week. Premature babies are 7% of births in our country and 5 thousand of these babies weigh less than a kilo and a half. A thousand do not even weigh a kilo. Today, despite the premature birth represent the first cause of neonatal mortality, 90% of premature babies manage to survive thanks to innovative techniques and therapies. There nutrition parenteral in the newborn plays a key role in ensuring the survival of premature babies, let's see what it is.
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Preterm infant feeding
The feeding of the premature baby is extremely important because it serves to guarantee the baby all those essential substances to complete his development. The mother is not always able to latch the premature infant to the breast which is fed with donated milk and stored in milk banks or with mother's milk drawn with a breast pump.
In more serious conditions, nutrition must take place in other ways. In general, the nutrition of the preterm infant can be:
- find out: with gastric tube or bottle
- parenteral: intravenously
Parenteral Nutrition Guidelines for the Newborn
Parenteral nutrition is a food for intravenous in infants who are too young to be able to feed at the breast or bottle. The baby is then fed and cared for thanks to special bags that contain medicinal products and nutrients. The bags can be ready-made or they can be prepared at the hospital pharmacy.
Virgilio Carnielli, director of neonatology at the G Salesi hospital in Ancona, explains that often failing to provide parenteral nutrition to premature babies is like making them die:
This type of nutrition becomes essential to meet the needs of the newborn to increase his weight and the development of his organs. In addition, 19 international studies tell us that parenteral nutrition can be provided immediately to the newborn because it is tolerated immediately
When parenteral nutrition is indicated? Experts from the Policlinico Gemelli in the city explain that this type of diet is indicated where it is not possible to administer the basic nutrients (glucose, amino acids, lipids, electrolytes, minerals, vitamins and trace elements) through the enteral route, that is, through the gastrointestinal tract and this circumstance occurs mainly in very premature babies, of weight less than 1000 grams.
La composition of the solutions to be administered to children is established by specialists through the use of computerized programs that are able to calculate, on the basis of precise parameters, the quantity and quality of the nutrients to be given.
In practice, thanks to parenteral nutrition it is possible to cover the nutritional needs from the first minutes of life in the very premature infant: however, when the newborn is stable it is extremely important to introduce enteral nutrition which can be started with a minimum amount of milk (20- 25 ml / kg / day), commonly called “minimal enteral feeding” (MEF), to stimulate the maturation of the intestinal mucosa.
Gavage nutrition in the newborn
By gavage nutrition we mean feeding through a gastric tube. Generally this type of feeding is necessary for children of less than gestational age 30 32-weeks. The tube is used to administer breast milk expressed through the breast pump.
The gavage feeding foresees the involvement of the mum who can make the baby suck his finger while he is being fed and can hold him and maintain skin-to-skin contact with him that helps him feel reassured, pampered and protected.Read also: Prevention and assistance in preterm labor according to the new guidelines
La enteral nutrition (NE) consists of giving the child the breast milk (which is however enriched with breast milk fortifying to increase above all the intake of proteins, fats, calcium, phosphorus and sodium) or, alternatively, the milk in specific formula for preterm births.
Generally this type of nutrition is indicated for babies capable of swallowing and where the sucking-swallowing mechanism is present (these are babies of gestation age between 30 and 32 weeks): a bottle or, alternatively, a bottle is used. cup or teaspoon.
Feeding with a spoon and then with a bottle can take place even when the baby is still fed with the tube: you can try to give him milk once or twice a day while holding him in your arms.
As the National Institute of Health explains, infants of gestational age of 32 weeks or more they are generally able to suckle milk from the breast and therefore breastfeeding can be started immediately. It is clear that at first the baby may not be able to suck a lot of milk and gets tired easily, so it is good to continue to give him the expressed milk with a cup or tube to be sure that the caloric intake is sufficient for the its growth.