Enteral nutrition practices among very preterm infants in neonatal units: a cross-country comparative study

Author:

Alyahya Wesam,AlSharfa Rayhana,Alduhbaki Noor,Al-Zahir Batool,Alqalaf Marwa,Alawfi Jumanah,Altwejri Hussah,Alessa Hanoof,Purayidathil Tunny,Khattab RabieORCID

Abstract

Purpose The objective of this study was to delineate and compare enteral nutrition (EN) practices among neonatal units across the Arabian Gulf countries. Design/methodology/approach A cross-sectional study was conducted by recruiting 255 clinicians working in neonatal units in the Arabian Gulf countries. Findings Out of 255 invited clinicians, 73 (29%) participated in the survey. Neonatal units used varied EN strategies, where feeding practices exhibited variability. The majority (74%) of units had a local standard feeding protocol, while 18% followed international protocols, and 8% did not adhere to a specific protocol. When maternal milk was not used, the main alternatives were preterm formula (67%) and predigested formula (14%). The age at which the first EN was commenced and the reported advancement rate showed significant variations among different units (p < 0.001). The initiation of fortification was primarily driven by reaching a specific enteral volume (commonly reported as 100 mL/kg/day) and addressing poor postnatal growth. Fortification practices did not differ significantly among professions, except for the initial fortification strength, where none of the dietitians and only 8.3% of neonatologists preferred full strength, compared to 28.6% and 21.4% of medical residents and nurses, respectively (p = 0.033). Originality/value This study marks the first exploration of EN practices in neonatal units, examining their local and cross-country variations. It provides valuable insights to guide local trials and foster global collaboration among neonatal units to establish a unified knowledge base, standardized practices and promote research and innovation, ultimately contributing to optimal feeding practices for very preterm infants.

Publisher

Emerald

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