Growth in the High-Risk Newborn Infant Post-Discharge: Results from a Neonatal Intensive Care Unit Nutrition Follow-up Clinic

Nutr Clin Pract. 2020 Aug;35(4):738-744. doi: 10.1002/ncp.10455. Epub 2020 Feb 21.

Abstract

Growth and nutrition in preterm infants have long-term implications for neurodevelopmental and cardiometabolic outcomes. Many infants are discharged from the neonatal intensive care unit (NICU) with growth restriction, but often without a specialized team to monitor postdischarge growth. At our institution, we addressed our ongoing concerns for the health and growth of these infants post-discharge by creating a Nutrition NICU Graduate Clinic. This clinic serves infants discharged from our NICU who were born with very low birth weight, had difficulty growing or feeding while inpatient, had a gastrostomy tube placed during hospitalization, or were deemed high risk for other reasons by our neonatal team, with the first clinic visit within 5 weeks of discharge. Data from our first 227 patients at time of discharge, first clinic visit, and any available second clinic visits are described. Anthropometrics show a high rate of extrauterine growth restriction at time of discharge with continued growth restriction at follow-up. Feeding regimens prescribed at discharge and variations from the prescribed regimen at time of follow-up are described. At time of first clinic visit, most patients (92.2%) required a medical or dietary intervention by our team. Our findings illustrate the need for early and specialized nutrition follow-up in this patient population to improve growth trajectory post-discharge.

Keywords: growth; medical nutrition therapy; neonatal intensive care unit; neonate; newborn infant; nutrition assessment; nutrition support.

MeSH terms

  • Aftercare / methods
  • Aftercare / statistics & numerical data*
  • Ambulatory Care Facilities
  • Anthropometry
  • Enteral Nutrition
  • Female
  • Gastrostomy
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature / growth & development*
  • Infant, Very Low Birth Weight / growth & development*
  • Intensive Care Units, Neonatal
  • Male
  • Nutrition Therapy / methods
  • Nutrition Therapy / statistics & numerical data*
  • Patient Discharge
  • Treatment Outcome