Understand the importance of having the appropriate number of dietitian FTEs assigned to the neonatal critical care unit to help improve growth parameters for preterm infants.

Background: Although the component of sucking and swallowing is present in the premature neonates at 28 weeks of gestation, the synchrony is irregular and oral feeding is difficult. The oral feedings become coordinated by 32–34 weeks of gestation and so the premature neonates are usually offered oral feeding at 32–34 weeks corrected gestational age. We had several neonates who were discharge home at ≤ 34 weeks of gestation. In order for them to be discharged at ≤ 34 weeks of gestation age, they must have had their oral feedings started earlier then 32 weeks of corrected age. Retrospective study was done to find out the earliest gestational age at which it would be safe to initiate oral feedings for early discharge from NICU. Methods: We reviewed all the charts for the neonates who were discharge home from our neonatal intensive care unit (NICU) at ≤ 34 weeks corrected gestational age from October 1, 2001 to December 31, 2002. The data was collected for gestational age, birth weight, sex, corrected gestational age, day of life the oral feedings were initiated, discharge weight and length of stay. Results: We had total 50 patients who were discharged home during the study period who were ≤ 34 weeks of corrected gestational age. Conclusion: Oral feedings can be initiated as early as 30 weeks of corrected gestational age in neonates. Early initiation of oral feedings may shorten the length of stay in NICU. Fig. 1

In this study we investigated the role of transpyloric (TP) feeds in apnea of prematurity suspected to be due to gastroesophageal reflux Method: Retrospective chart review of premature infants on TP feed with documented apnea. Results:- Out of 32 eligible infants, 12 with documented apnea were included in the study. Though TP feeds significantly reduced (p <.05) the average apnea rate in the whole group, two infants did not show any reduction of number of apneas. The remaining 10 showed even stronger correlation between TP feeds and reduction of number of apneas. (p < .01). After discontinuation of TP feeds 1 required antireflux surgery, one was transferred to another hospital and 10 were discharged home. No TP tube related complication was documented. Conclusion:- The association between GER and apnea is difficult to establish even with sophisticated tests. In a properly selected population, TP feeds can be used for diagnosis and management of gastroesophageal reflux associated apnea.