Categories: Neonates & Pediatrics

Nutrition and Fluids in NICU

Nutrition and Fluids in the NICU

Nutrition for babies in the Neonatal Intensive Care Unit

The feeding process i.e. the nutrition and fluids in NICU for the babies is fairly different from feeding the pink babies. When newly born babies are sick or premature, they are frequently not in good health to take nutrition like breastfeed or a feeder. The preterm babies may not be capable to suck efficiently for nutrition. Because their gastrointestinal tracts may not be developed sufficient to digest feedings. Offspring who have unstable healthiness are frequently not capable to take consistent feedings. The newly born with umbilical catheters and those who require the help breathing, such as with an automated ventilator, possibly will not be capable to be fed. Because of the risk of complications such as aspiration. Aspiration is the breathing food into the lungs.

Intravenous fluids and parenteral nutrition

Countless babies admitted in the NICU take vital fluids and electrolytes through an intravenous tube (IV tube) in a vein. Nearly all babies may require a special type of fluid called parenteral nutrition (PN) or hyperalimentation. These nutrients they require till they are capable to take milk feedings. The careful tailoring of IV fluids and PN contents for each baby is crucial.

These fluids have fats, calories, protein, and electrolytes. These electrolytes comprise

  • Sodium
  • Potassium chloride
  • Magnesium
  • Calcium

All babies need calories, protein, and fats for strong development and progress.

Therefore, the fluids, electrolytes, and vitamins are compulsory for the well-functioning of the systems of the body.

How to assess the need for fluids?

Blood tests help illustration how much of each item a child desires. The quantity of each nutrient may be increased or decreased as desired. The weight and urine amount of the baby is followed every day. This can also support to assess the need of fluids in a baby.

Few babies have too much imbalance of certain electrolytes or other ingredients in the blood. As an outcome, some complications include:

  • Hypernatremia

Hypernatremia is the high quantity of sodium in the blood.

  • Hypoglycemia

Hypoglycemia is low sugar in the blood. It is typically treated with IV fluids.

  • Hypocalcemia

This is low blood calcium level.

  • Hyperkalemia

Hyperkalemia is high amounts of potassium in the blood. It can be identified by blood tests or by heart rate patterns in baby.

  • Hyperglycemia

Hyperglycemia is high amounts of glucose or sugar in the blood. It is identified by blood tests.

When the babies are ready for milk feedings?

Babies younger than 28 weeks’ can get advantages from milk feedings. The preterm babies are given feedings in very minor quantities. This is usually through tube feeding. These are actually called trophic feedings. Trophic means that these sensations help the digestive tract developed and mature.

The quantity of milk is gradually increased over time. Once the baby is capable to have sufficient amounts of milk feedings, IV fluids and PN can be gradually diminished.

Sick babies are not strong enough to suck well. Preterm babies may not be bodily mature enough to synchronize

  1. Sucking
  2. Swallowing
  3. Breathing

So, they may be too feeble to suck for long times. Sucking is the early sign that a baby is getting prepared to exercise feeding by mouth. It also has a soothing effect. The finest place for the tiny baby to exercise sucking and learn to feed is at the breast of the mother. But minor pacifiers for premature babies may be used for ease and practice when mothers are not accessible. It may help early babies to have drops of their mother’s colostrum by mouth even if they are not capable to feed by mouth so far.

Feeding the tiny babies in the NICU

These are some methods babies may be fed in the NICU:

  • Gavage or tube feedings

The preterm babies most frequently (those younger than 32 to 36 weeks) cannot be fed from the breast or feeder. Gavage feedings may be desirable until the baby picked up the suck well. For tube or gavage feedings, a minor flexible tube is placed into the nostril or mouth of the baby. It is then passed down to the stomach of the baby. Therefore, the tube is generally left in place until the baby is capable to feed by mouth ongoing.

At first, minute amounts of breastmilk or formula are set through the feeding tube. Because of their small stomach size, very tiny babies may be fed using a pump that slowly gives the milk in small amounts. As the babies grow, they are able to slowly take larger amounts at each feeding. Before each tube feeding, a baby may be checked for residual. This is the amount of milk in the stomach left over from the last feeding. If the amount of residual is more than expected, it may mean the baby is not digesting milk well.

  • Cup feedings

Also known as spoon feedings. Nearly all NICUs use easy flexible feeding cups or superficial feeding spoons instead of jugs or bottles for babies who are at stage of breastfeeding.

  • Nipple feedings

Feeding practice from the breast or feeder may start as soon as babies are steady and are capable to suck healthy. The baby will probably start to practice feeding by the mouth while quiet being tube fed. Therefore, even if your baby shows concentration and contribution in a feeding, it can be exhausting.

We need to pay care to the cues of the baby that display he or she is exhausted. In the case of using the feeder bottle, it is very important to help the baby pace the feeding. The learning of feeding with the help of a mouth is a slow development process. It can take several weeks for preterm babies.

Therefore, it is very normal to take only intermittent small quantities by the feeder bottle or breast. In order to determine out how much milk a baby is receiving by the breast, then he or she can be weighed before and after the feeding by the use of a special scale. As the baby increases the quantity then he or she can securely and contentedly take by nipple, the quantity in the tube feedings can be reduced.

Why breastmilk is significant and how lactation specialists can help?

  • The milk of a mother is the number one milk for all tiny babies, particularly the most preterm babies. Breastmilk of a mother has all the essential nutrients required for the healthy growth and development.
  • The baby formulas are designed to be close to human milk. Therefore, most of these are based on cow milk protein. That is actually different from the human protein. So, the proteins and fats in breastmilk of a mother are more effortlessly digested. Because of these alterations, the formula may not be as well accepted or tolerated by a baby.
  • Since the breastmilk has antibodies and other immune factors from the mother. These can help protect tiny babies from multiple infections. This is somewhat that baby formulas don’t have this. This type of protection is more important when babies are not healthy or preterm and have a higher risk of getting an infection.

Necrotizing enterocolitis

It is a very hazardous disorder in preterm. It is very common in those tiny babies who don’t acquire breastmilk. Having more breastmilk feedings also appears to lead to more growth of the brain of preterm babies.

  • Mostly premature babies may require supplements added to breastmilk for their proper growth. This is done in order to meet their increased needs for protein, calcium, and phosphorus.
  • Even if the baby responds to breastfeed, the mother can pump the breastmilk and it may be used for gavage or nipple feedings.
  • Depending on the quantity of milk needed for baby feedings, donor milk or baby milk formula may need to be given for a short time in addition to the mother milk of the baby. Therefore, the donor milk is sterilized before it is given. Because of this reason, it may lose some of the nutritional value. But it is more obliging for preterm infants than formula. It is a vital choice when the breastmilk of the mother is not available.

Lactation specialist

The Certified lactation consultants are the nurses or other healthcare workers who are particularly trained and expert to help women with breastfeeding. In the NICU, these workers may help the baby with breastfeeding. They may teach about pumping and storing of the breastmilk for the use of baby.

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