aung myo zaw(nutrition in preterm and congenital hypotrophy)

Nutrition in Preterm

and Congenital

hypotrophy

Nutrition in Preterm

and Congenital

hypotrophy

Presented by : Dr. Aung Myo ZawSupervised by : Dr. A.N Goraynova

Causes of Preterm and Congenital Hypotrophy

Maternal factors Maternal infection Hypertension Diabetes Malnutrition, Anemia Alcohol, drugs Cigarette smoking Placenta previa, Placenta abruption

Fetal factors Multiple pregnancy Congenital malformation Infection Fetal Hypoxia, Fetal

distress Rh incompatible Intrauterine growth

retardation

Introduction

Premature infants have greater nutritional needs to achieve optimal growth in the neonatal period than at any other time of their life

Corrects growth restriction at birth and achieves appropriate rates of weight gain

Pathophysiology of no entral feeding Gut atrophy, Luminal starvation, Bacterial translocation, Impaired immune function

Advantage of Early Minimal Entral Feeding

Faster weight gain Less feeding intolerance Less need for phototherapy, Enhanced serum gastrin concentrations Enhanced maturation of the small intestine

function, Lower bilirubin concentrations Shorter duration of hospitalization Not increase the incidence of necrotizing

enterocolitis

Comparison of Breast milk and Preterm formula

Breast milk Soft, easily-digestible

whey Rich lactose,

oligosaccharides, which promote intestinal health

Lactoferrin, Lysozyme,

sIgA

Preterm formula More energy, protein,

Ca++, Ph, Mg, vitamins Lacks of antibodies

and other substrates

Contraindications to Entral Feeding Assessment of the newborn by the Apgar’s

score below 7 points in severe neonatal asphyxia

Birth trauma Convulsions Respiratory distress syndrome, as well as

profound prematurity Severe developmental defects (gastro-

intestinal tract, oral facial organs, heart, etc.)

Aim of study

•To assess the effectiveness of nutrition in

Preterm and Congenital hypotrophy

Patients and methods

Retrospective study 30 newborns in Neonatal department and

Neonatal Intensive care unit in Thushinskaya Children’s Hospital from January to May,2007

Difference Between Preterm and Term newborns

20

Difference between Preterm and Term Preterm(<37 week)

83.33%

Birth weight in Preterm and Congenital Hypotrophy

Birth weight(<2.5kg)

Mother’s has disease or not

Disease(+) -23(76.67%)

Intrauterine infection -15 (50%)

Others conditions -8 (26.67%)

No disease -7(23.33%)

Intrauterine infection (n=15)

Other conditions(n=8)

Newborn’s numbers in Intensive Care Unit

Types of nutrition used in Intensive Care Unit

3.33%

Volumes of nutrition giving in Intensive Care

Unit(Preterm)

Changes in body weight in Intensive Care Unit (Preterm)

Types of nutrition used in Neonatal Department

Body weight changes in different forms of nutrition(g/day)

31.1

Results

Conclusion

Preterm and Congenital hypotrophy are typical problems

Preterm formula plus breast feeding is most effective for preterm and small for gestational age

But if breast milk is unable to feed , preterm formula is most preferred for preterm newborn and congenital hypotrophy