Teams are hard at work implementing change and piloting creative approaches. To highlight one activity among many this month: those teams currently using feeding protocols have shared them with the other teams in this initiative.
Feeding guidelines provide a standardized approach to enteral nutrition for the Very Low Birth Weight Infant (VLBW) and minimize periods where feedings are held. Providing early small volume feeds using mom’s colostrum every chance you get as soon as you get it is an important aspect of most feeding guidelines and sends a powerful message to mother’s emphasizing the importance of fresh human milk.
Comprehensive feeding guidelines address initiation and advances in volume, fortification, the need for additional protein and how to manage residuals. Several studies inform advancement of feeds, fortification and additional protein; however more studies are needed to guide practice of when to start feedings and the use of donor milk. Despite the need for more research and the variations between units on the components of a feeding guideline, a systematic review of standardized feeding protocols in 6 units showed reduction of NEC from 4.6% to 2.2%.
