Preterm feeding recommendations are achievable in large-scale research studies
Bibliographic record
Abstract
The INTERGROWTH-21 st Project aimed to produce international, prescriptive, postnatal growth standards for preterm infants born to healthy, well-nourished mothers receiving adequate antenatal care. There is little information available regarding optimal postnatal growth among uncomplicated preterm newborns. We describe how the preterm infants contributing to the standards followed evidence-based feeding recommendations. In the Fetal Growth Longitudinal Study (FGLS), a component of the INTERGROWTH-21 st Project, fetal growth was monitored by ultrasound from <14 weeks’ gestation until birth in pregnancies at low risk of adverse outcomes. All preterms (≥26 +0 and <37 +0 weeks’ gestation) were followed up during infancy. Internationally-accepted feeding recommendations for preterms, agreed by the INTERGROWTH-21 st Neonatal Group, were implemented at each study site. Standardised questionnaires served to record information on their feeding practices. Feeding data were collected from 201 eligible preterms. The median (interquartile range, IQR) gestational age at birth was 36.0 (35.0 – 36.6) weeks. The prevalence of any breastfeeding was 82 % within 72 h of birth, 96 % at 2 weeks, 82 % at 4 months and 70 % at 8 months postnatal age. The figures for exclusive breastfeeding were 51 % within 72 h of birth, 72 % at hospital discharge, 49 % at 4 months, 38 % at 5 months and 12 % at 6 months. Complementary foods were introduced at a median (IQR) postnatal age of 6.0 (5.1 – 6.8) months. Most preterms were exclusively breastfed upon hospital discharge, and breastfeeding remained a substantial source of nutrition throughout the study. Recommendations, centred on breastfeeding, were adequately followed within the expected variation of such diverse settings.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.460 | 0.720 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.005 | 0.009 |
| Science and technology studies | 0.002 | 0.003 |
| Scholarly communication | 0.011 | 0.006 |
| Open science | 0.003 | 0.009 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".