ABSTRACT
Background: Preterm neonates post-natal growth should be similar to the intrauterine growth of the fetus of the same gestational age. This study aims to' evaluate the effects of full enteral feed (60 ml/kg/day of human milk on day one, 20ml/kg/day during feeding advancement) started from day one of life (intervention) in enhancing'' the regain of birth weight compared to that of standard feed (both human milk feeds and intravenous fluid) in a group.Methods: Babies were started on enteral feeds with human milk at the rate of 60ml/kg/day from day one and progressed by increments of 20 ml/kg/day up to maximum enteral feed of 180 ml/kg/day. The primary outcomes like Number of days taken to regain the birth weight, Duration of hospital stay, Incidence of Necrotising Enterocolitis (NEC), Incidence of sepsis, need for intravenous fluid therapy was assessed and statically analysed.Results: Full enteral feeding group infants had lesser days of intravenous fluids. Full enteral feeding group regained birth weight at a mean age of 17.37'4.9 days and in the standard feeding group, birth weight was regained at a mean age of 19.8'4.3. Full enteral feeding group regained birth weight at a mean age of 13.12'2.17 days and in standard feeding group at a mean age of 15.38'3.57and this was statistically significant (p - 0.009). Full enteral feeding group babies had lesser number of days of intravenous fluids compared to babies in standard feeding group. It was statistically significant (p - 0.003).Conclusions: Full enteral feeding practices from day one of life with human milk is feasible, cost effective and safe in hemodynamically stable VLBW infants and results in earlier regain of birth weight
ABSTRACT
Background: Neonatal deaths account for 47% of all deaths in children younger than 5 years globally. More than a third of deaths are due to preterm related complications. Understanding the factors contributing to preterm deaths and pattern of mortality is needed to implement interventions that are essential in improving neonatal survival.Methods: This was a retrospective study done in neonatal intensive care unit, Institute of Child Health (ICH) and Hospital for Children, Chennai, a tertiary care regional center. All preterm (<32 weeks) deaths registered in the neonatal medical records from 1st of January 2018 to 31st of December 2018 were analysed. Primary causes of deaths were analysed by two consultants. When there were more than one cause contributing to responsible for death the most significant problem was taken as the cause of death.Results: Overall neonatal mortality was 312 (14.2%) of 2189 neonates. Out of 148 admissions in the study population mortality was 74.2% (26 of 35) for extreme preterm (<28 weeks) infants and 42.7% (48 of 113) for very preterm (28 to 32 weeks) infants. Predominant causes of death were sepsis 44.5% (33), prematurity-related complications 37.8% (28) followed by congenital anomalies 12.1% (9) and miscellaneous causes 2.7% (2). Respiratory Distress Syndrome (RDS) and Intra Ventricular Haemorrhage (IVH) attributed to 75% (21/ 28) of deaths among prematurity-related complications.Conclusions: This study identified sepsis; prematurity related complications were the predominant causes of mortality in the extreme to very preterm population. Understanding the specific causes of preterm mortality would help to implement interventions to promote their survival.