The video discusses an updated approach to feeding premature infants, specifically focusing on the "high-risk regime." Previously, feeds were withheld for several days, but the current practice is to initiate trophic feeds as early as possible. The high-risk regime involves starting feeds at a rate typically used for smaller babies (e.g., a 1500g baby fed as if they were 1000g). Feeds are fortified as they would be for any small premature infant. The rate of increase differs between high-risk and standard-risk regimes: high-risk increases by 10-15 ml/kg/day, while standard-risk increases by 15-30 ml/kg/day. However, for Intrauterine Growth Restriction (IUGR) babies, if they tolerate the high-risk regime well and their weight is above a certain threshold, the feeding rate can be accelerated. The initial few days of feeding are highlighted as critical.

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In terms of feed approach to feeding these babies, again, previously we used to hold feeds for a few days before we start, but now we don't hold feeds. We start trophic feeds as early as possible. And we go with the high-risk regime.

Suppose this baby is 1,500 g, we would use the regime used for 1,000 g. You'd still fortify the feeds as you would for a small premature baby and the rate of increase again, the high-risk regime is 10 to 15 ml per kilo per day increment, while the standard risk is 15 to 30 ml per kilo per day increment.

So, if the baby is following the high-risk regime for a few days and baby is tolerating well, and the weight is above a certain cutoff, you can go faster with the feeds in the IUGR babies. So, the first few days is critical.

Feeding the preterm IUGR babies?

In terms of feed approach to feeding
these babies, again, previously we used
to hold feeds for a few days
before we start, but now we don't hold
feeds. We start trophic feeds as early
as possible.
And we go with the high-risk regime.
Suppose this baby is 1,500 g, we would
use the regime used for 1,000 g.
You'd still fortify the feeds as you
would for a small premature baby and the
rate of increase
again, the high-risk regime is 10 to 15
ml per kilo per day increment, while the
standard risk is 15 to 30
ml per kilo per day increment.
So, if the baby is following the
high-risk regime for a few days and baby
is tolerating well, and the weight is
above a certain cutoff, you can go
faster with the feeds in the IUGR
babies. So, the first few days is
critical

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Feeding the preterm IUGR babies?

Transcription