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[Effect of the method of feeding on the physical development of infants born with symptoms of intrauterine dystrophy].

In the Clinical Department of Metabolic Studies of the National Research Institute of Mother and Child the attempt was made to stimulate physical development of S-F-D infants through introducing modifications in standard feeding in order to make up for the deficits of foetal age. In the years 1970-1975, 118 infants were under observation: 44 out of this group, in the Clinical Department, 70 in the Outpatient Clinic of Infant Nutrition disorders, 4 were observed both in the Clinical Department and in the Outpatient Clinic. The control group of 40 S-F-D- infants was observed in the Child Outpatient Department of Wola Borough of Warsaw. Foetal age of S-F-D infants underwent anthropometric measurements, psychological and neurological examinations. Investigations of haematological and biochemical indices were also carried out. Physical development of children in 4 (S,G,H,C) dietary groups was observed and compared with the control group. Initial diet differed from the standard diet, used at the National Research Institute of Mothers and Child, by excluding gluten and by replacing saccharose with glucose. In other diets (G, H and C) milk formulas with different quantitative and qualitative protein and fat content were enriched with unsaturated fatty acids. Longitudinal analysis included 61 infants from single pregnancies which were put on regular and sufficiently long (5-12 months) diet. Evaluation of physical development was based on the analysis of mean values, increments and rate of growth of body--length, body weight, arm, scapular and abdominal skin-fold thickness. These data are presented in Tables I-IX, variate curves of individual features in Figures 1-9. Somewhat higher developmental indices were observed in the group of infants fed enriched formulas with unsaturated fatty acids. Growth rate of skin-fold thickness in group S, was extremely intensive all the first year through and decreasing physiological tendencies were not observed in 4th trimester of life.

Age Factors↗

Survey: methods of feeding low-birth-weight infants.

The directors of 269 neonatal intensive care units were surveyed to determine how low-birth-weight infants are being fed. Feeding practices were based on birth weight, with the smallest infants receiving parenteral nutrition for the longest time after birth. First enteral feedings usually were given by the nasogastric route in infants with birth weight of 1,500 g or less, but transpyloric feedings were used in 15% of neonatal intensive care units for infants with birth weight less than 1,000 g. The initial enteral feeding was sterile water in 56% to 58% of the neonatal intensive care units, but was glucose water or milk in the others. Once enteral feeding was established, both human milk from the infant's own mother and commercial formula were used. Whether human milk was mixed or alternated with infant formula, or whether some infants in the nursery were fed human milk while others were fed formula, was not determined. The type of infant formula fed to low-birth-weight infants depended on the infant's birth weight and clinical status. Both human milk and formula were supplemented with energy (fat or carbohydrates) and vitamins, but not with calcium and phosphorus, in most neonatal intensive care units. Some vitamins, such as vitamins A and D, may be oversupplemented, while others, such as folic acid, may be undersupplemented.

Birth Weight↗

Percutaneous endoscopic gastrostomy: a preferred method of feeding tube gastrostomy.

Percutaneous endoscopic gastrostomy was attempted in 16 patients using local anesthesia and intravenous meperidine and diazepam sedation. The procedure was shown to be safe, easy to perform, and avoided the need for laparotomy. We suggest percutaneous endoscopic gastrostomy be the preferred route of alimentation in those patients requiring feeding gastrostomy.

Enteral Nutrition↗