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Improved Use of Human Milk, Growth, and Central Line Utilization With Standard Feeding Roadmap in an Academic NICU.

Publication ,  Journal Article
Kohler, JA; Fowler, JO; Moore, RT; Higginson, JD
Published in: Nutr Clin Pract
August 2020

BACKGROUND: Before the initiation of a standardized feeding roadmap in our regional, level IV academic neonatal intensive care unit, utilization of central lines was high, and initiation of enteral feeds delayed in the very low-birth-weight population (<1500 g). Given our review of the literature, it appeared that the standardization of feeding advancement would likely result in improved performance in both issues. METHODS: This was a retrospective cohort comparison of very low-birth-weight patients before initiation of any feeding roadmap with a second cohort following completion of the final roadmap. Infants were examined retrospectively in 2 historical cohorts: Phase 1, infants fed before roadmap development and rollout, October 1, 2012-March 31, 2013; and Phase 2, following promulgation of the final feeding roadmap, January 1, 2017-June 30, 2017. RESULTS: During Phase 2, we observed a significant reduction in median (interquartile range) days to first feed (3 [1] vs 1 [1] [P < 0.0001]) and utilization of a second central line (35% vs 12% [P < 0.01]). Weight gain was significantly improved from before roadmap implementation to final, mean (SD) (g/d, 21 [5] vs 24 [4]; [P < .0001]). Percentage of first enteral feedings that were human milk also increased significantly from 71% to 91% (P = 0.0007). CONCLUSION: Implementation of a standardized feeding roadmap was associated with a reduction in days to first enteral feeds, an increase in the primary use of human milk for initiation of enteral feeds, and a decrease in the utilization of central lines while improving weight gain in very low-birth-weight infants.

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Published In

Nutr Clin Pract

DOI

EISSN

1941-2452

Publication Date

August 2020

Volume

35

Issue

4

Start / End Page

703 / 707

Location

United States

Related Subject Headings

  • Weight Gain
  • Retrospective Studies
  • Nutrition & Dietetics
  • Milk, Human
  • Male
  • Intensive Care Units, Neonatal
  • Infant, Very Low Birth Weight
  • Infant, Newborn
  • Humans
  • Health Plan Implementation
 

Citation

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Kohler, J. A., Fowler, J. O., Moore, R. T., & Higginson, J. D. (2020). Improved Use of Human Milk, Growth, and Central Line Utilization With Standard Feeding Roadmap in an Academic NICU. Nutr Clin Pract, 35(4), 703–707. https://doi.org/10.1002/ncp.10441
Kohler, John A., Jennifer O. Fowler, Ryan T. Moore, and Jason D. Higginson. “Improved Use of Human Milk, Growth, and Central Line Utilization With Standard Feeding Roadmap in an Academic NICU.Nutr Clin Pract 35, no. 4 (August 2020): 703–7. https://doi.org/10.1002/ncp.10441.
Kohler JA, Fowler JO, Moore RT, Higginson JD. Improved Use of Human Milk, Growth, and Central Line Utilization With Standard Feeding Roadmap in an Academic NICU. Nutr Clin Pract. 2020 Aug;35(4):703–7.
Kohler, John A., et al. “Improved Use of Human Milk, Growth, and Central Line Utilization With Standard Feeding Roadmap in an Academic NICU.Nutr Clin Pract, vol. 35, no. 4, Aug. 2020, pp. 703–07. Pubmed, doi:10.1002/ncp.10441.
Kohler JA, Fowler JO, Moore RT, Higginson JD. Improved Use of Human Milk, Growth, and Central Line Utilization With Standard Feeding Roadmap in an Academic NICU. Nutr Clin Pract. 2020 Aug;35(4):703–707.
Journal cover image

Published In

Nutr Clin Pract

DOI

EISSN

1941-2452

Publication Date

August 2020

Volume

35

Issue

4

Start / End Page

703 / 707

Location

United States

Related Subject Headings

  • Weight Gain
  • Retrospective Studies
  • Nutrition & Dietetics
  • Milk, Human
  • Male
  • Intensive Care Units, Neonatal
  • Infant, Very Low Birth Weight
  • Infant, Newborn
  • Humans
  • Health Plan Implementation