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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