13 alim post dimix
DESCRIPTION
ALIMENTAZIONE PRETERMINE DOPO DIMISSIONETRANSCRIPT
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Alimentazione Alimentazione dopo la dopo la
dimissionedimissioneLuca MaggioLuca Maggio
TIN – UCSC – RomaTIN – UCSC – Roma
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Lucas A. Nutrition, Growth and Development of Postdischarge Preterm Infants. In: Post-hospital Nutrition of the Preterm Infant. Report of the 106th Ross Conference on Pediatric Research, Colorado Springs, Colorado, August 18–20, 1995. Columbus, OH: Ross Products Div, Abbott Labs; 1996:81-89
Stop Supplementazione LMFormula per Neonati ATDivezzamento Standard
18 mesi > 30 % Peso < 10° pc7-8 anni > 20 % Peso < 10° pc
Dimissione
> 50 % Peso < 10°pc
VLBWVLBW
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-1,48
-1,93
-1,81
-1,54
-2,00
-1,75
-1,50
-1,25sd
s1a
3a2aD
ZScore Peso
-0,45 +0,12
+0,27
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-0,74
-1,33-1,48
-1,34
-2,00
-1,75
-1,50
-1,25
-1,00
-0,75
-0,50sd
s
ZScore CC
1a
3a2aD
-0,49 -0,15 +0,14
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B.Latal-Hajnal, K.Von Siebenthal, H.Kovari, H.U. Bucher, R.H Largo. Postnatal growth in VLBW infants: significant association with neudevelopmental outcome. J Pediatr 2003 143:163-70
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Lucas A, King F, Bishop NB. Postdischarge formula consumption in infants born preterm. Arch Dis Child 1992;67:691-2
ml/kg/dml/kg/d
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Lucas A, King F, Bishop NB. Postdischarge formula consumption in infants born preterm. Arch Dis Child 1992;67:691-2
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Soluzioni ?
1. Calorie Proteine ?
2. [Latte] IperOsm
3.Formula PT Eccessi (Vit D)
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Wheeler RE, Hall RT. Feeding of premature infant formula after hospi-tal discharge of infants weighing less than 1800 g at birth. J Perinatol. 1996;16:111–116
Cooke RJ, Griffin IJ, McCormick K, et al. Feeding preterm infants after hospital discharge: effect of dietary manipulation on nutrient intake and growth. Pediatr Res. 1998;43:355–360
Cooke RJ, McCormick K, Griffin IJ, et al. Feeding preterm infants after hospital discharge: effect of diet on body composition. Pediatr Res. 1999;46:461– 464
Cooke RJ, Embleton ND, Griffin IJ, Wells JC and McCormick KP. Feeding Preterm Infants after Hospital Discharge: Growth and Development at 18 Months of Age Pediatr Res 2001; 49: 719–722
Latte per Prematuri Latte per
Prematuri
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RJ Cooke, Embleton ND, IJ Griffin, JCK Wells, K.McKormick. Feeding preterm infants after hospital discharge: growth and development at 18 months of age. Pediatr Res 2001;49:719-22
M F
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Lucas A, Bishop NJ, King FJ, Cole TJ. Randomised trial of nutrition for preterm infants after discharge. Arch Dis Child. 1992;67:1413–1414
Atkinson SA, Randall-Simpson J, Chang M, Bosco P. Randomized trial of feeding nutrient-enriched vs standard formula to premature infants during the first year of life. Pediatr Res. 1999;45:276A
Jane D. Carver, Paul Y. K. Wu, Robert T. Hall, Ekhard E. Ziegler, Roberto Sosa, Joan Jacobs, Geraldine Baggs, Nancy Auesta and Beate Lloyd. Growth of Preterm Infants Fed Nutrient-Enriched or Term Formula After Hospital Discharge Pediatrics 2001;107:683– 689
Chan GM. Growth and bone mineral status of discharged very low birth weight infants fed different formulas or human milk. J Pediatr. 1993;123: 439–443
Brunton JA, Atkinson SA, Saigal S. Growth and body composition in infants with bronchopulmonary dysplasia up to 3 months corrected age: A randomized trial of high-energy nutrient-enriched formula fed after hospital discharge. J Pediatr 1998;133:340 –345
Lucas A, Fewtrell MS, Morley R, Singhal A, Abbott RA, Isaacs E, StephensonT, MacFadyenUM and Clements H. Randomized Trial of Nutrient-Enriched Formula Versus Standard Formula for Postdischarge Preterm Infants Pediatrics 2001;108:703–711
PDF PDF
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Caratteristiche PDF
Tutto Kal/Proteine
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Standard formula
Postdischarge formula
Preterm formula
Protein (g) Energy (kcal) Calcium (mg) Prot/100kcal
1.4-1.5 67
35-54 2.2
1.8-1.9 72-74 70-80 2.5
2.2-2.3 80-90
100-108 2.8
Composition of infant formulas (per dl)
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Brunton J, Saigal S, Atkinson SA. Growth and body composition in infants with bronchopulmonary dysplasia up to 3 months corrected age:A randomized trial of a high-energy nutrient-enriched formula fed after hospital discharge.J Pediatr 1998;133:340-5
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Proteine + 27 %
Calorie + 6 %
Calcio + 79 %
Fosforo + 23 %
Sodio + 29 %
Potassio + 37 %
Zinco + 76 %
Rame + 36 %
Mn + 47 %
Carnitina +
Vit B1 + 56 %
Vit B2 + 82 %
Vit B6 + 128 %
Vit B12 + 43 %
Folati + 635 %
Vit C + 117 %
Vit D + 30 %
Vit E + 212 %
Vit K + 122 %
Ac Pan. + 74 %
Lucas A, Fewtrell MS, Morley R, Singhal A, Abbot RA, Isaacs E, Stephenson T, MacFadyen UM, Clements H. Randomized trial of nutrient-enriched formula versus standard formula for postdischarge preterm infants. Pediatrics 2001;108:703-11
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RisultatiAPM
Eff.TraiettoriaPT > ATM > F
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JD Carver, PYK Wu, RT Hall, EE Ziegler, R Sosa, J Jacobs, G Baggs, N Auestad, B Lloyd. Growth of preterm infants fed nutrient-enriched or term formula after hospital discharge. Pediatrics 2001;107:683-89
< 1250 g
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Brunton J, Saigal S, Atkinson SA. Growth and body composition in infants with bronchopulmonary dysplasia up to 3 months corrected age:A randomized trial of a high-energy nutrient-enriched formula fed after hospital discharge.J Pediatr 1998;133:340-5
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Lucas A, Fewtrell MS, Morley R, Singhal A, Abbot RA, Isaacs E, Stephenson T, MacFadyen UM, Clements H. Randomized trial of nutrient-enriched formula versus standard formula for postdischarge preterm infants. Pediatrics 2001;108:703-11
9 Mo PDF TF p
Wt SDs - 0.86 - 1.22 0.03
L SDs - 0.28 - 0.64 0.029
HC SDs - 0.30 - 0.20 0.60
18 Mo PDF TF
Wt SDs - 1.01 - 1.10 0.60
L SDs - 0.28 - 0.60 0.029
HC SDs - 0.88 - 0.58 0.13
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Lucas A, Fewtrell MS, Morley R, Singhal A, Abbot RA, Isaacs E, Stephenson T, MacFadyen UM, Clements H. Randomized trial of nutrient-enriched formula versus standard formula for postdischarge preterm infants. Pediatrics 2001;108:703-11
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DubbiComposizione
Consumo (cc vs Kal)TargetDurata
Significatività Clinica
Sviluppo NMLatte Materno
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Type of milk InfantsInfantsAuthors
Nutritional follow-up studies in preterm infants
Lucas et al
Wheeler et al
Chan et al
Cooke et al
Brunton et al
Carver et al
Lucas A et al
Rigo et al
SF, PDF
HM, SF, PTF
HM, SF, PDF, PTF
SF, PTF
SF, PTF
SF, PDF
SF, PDF
SF, PDF
Preterm <1850g
Preterm <1850g
Preterm <1650g
Preterm <1750g, <34 w.
VLBW <1500g + BDP
< 37 w.; <1800g
< 37 w.; <1750g
< 34 w.; <1800g
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DurationDuration N. infants
Follow-up studies in premature infants:standard (SF) versus enriched formula
(EF)
Lucas et al (1992)
Wheleer RE et al (1996)
Chan GM et al (1993)
Brunton JA et al (1997)
Cooke R et al (1998)
Carver JD et al (2001)
Lucas A et al (2001)
Rigo J et al (2001)
9 months
6 months
8 weeks
3 months
6 months
12 months
18 months
2 months
31
54
59
60
96
125
229
33
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Lucas A, Fewtrell MS, Morley R, Singhal A, Abbot RA, Isaacs E, Stephenson T, MacFadyen UM, Clements H. Randomized trial of nutrient-enriched formula versus standard formula for postdischarge preterm infants. Pediatrics 2001;108:703-11
9 Mo PDF TF BF
Wt SDs - 0.86 - 1.22 -1.31
L SDs - 0.28 - 0.64 -0.93
HC SDs - 0.30 - 0.20 -0.15
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Crescita durante lo studio Crescita durante lo studio (1)(1)
o + 37 g+ 37 g (Ic 95% 10, 64) Peso (Ic 95% 10, 64) Peso
o + 1,2 cm+ 1,2 cm (Ic 95% 0.5, 1.9) (Ic 95% 0.5, 1.9) LunghezzaLunghezza
Crescita dopo lo studioCrescita dopo lo studio (2) – (2) – Fu 18 mFu 18 mo + 24 g (Ic 95% -4, 52) Peso + 24 g (Ic 95% -4, 52) Peso
o + 0.98 cm+ 0.98 cm (Ic 95% 0.3, 1.7) (Ic 95% 0.3, 1.7) LunghezzaLunghezza
o + 0.03 cm (Ic 95% -0.4, 0.4) + 0.03 cm (Ic 95% -0.4, 0.4) C.CranicaC.Cranica
Outcome NPMOutcome NPM (2) (2)o + 0.23 (Ic 95% -3, 3.5) MDI+ 0.23 (Ic 95% -3, 3.5) MDI
o + 0.56 g (Ic 95% -2, 3) PDI+ 0.56 g (Ic 95% -2, 3) PDI
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