147 A Standardized Daily Feeding Protocol Improves Nutrition and Overall Health in Premature Low-birth-weight Infants
Bibliographic record
Abstract
As survival rates for preterm infants improve, there is increasing evidence that early diet can influence long-term health outcomes (1–3). Despite this, optimal management of nutrition in preterm infants remains challenging as evidence-based interventions are often not applied uniformly to daily practice. The development of standardized feeding protocols in the NICU aims to optimize postnatal growth and improve health outcomes of infants. To determine the impact of a standardized daily feeding protocol on nutrition and neonatal outcomes in low-birth-weight premature infants. This was a retrospective chart review evaluating infants born less than 34 + 0 weeks gestational age (GA) and birth weight (BW) less than 1500 grams who were admitted to the NICU at a Canadian Health Sciences Centre. Infants born between October 1, 2016 to April 1, 2017 comprised the general pre-intervention group and those born between April 2, 2017 to October 1, 2018 comprised the standardized nutrition group. Outcomes included initiation and weaning of parenteral nutrition, initiation of human milk fortifier, initiation and advancement of enteral feeds, change in weight Z score, neonatal morbidities and severity of medical illnesses throughout the hospitalization using the Nursery Neurobiological Risk Score (NBRS) (4).T-tests and chi-square tests were used to analyze outcomes. A total of 56 patients met inclusion criteria. 30 infants served as the general nutrition control group and 26 infants received the new standardized nutrition protocol. There were no baseline differences between groups with respect to BW, GA, sex, or being small for GA. Infants who participated in the standardized feeding protocol started enteral feeds earlier (p=0.05), received human milk fortification (HMF) at lower weights (p=0.033), had fewer days on CPAP (p=0.021) and demonstrated lower rates of BPD (p=0.018). This group also demonstrated a lower NBRS during their stay (p=0.014). Remaining analyzed parameters did not show statistically significant differences. Use of a standardized feeding protocol in a Level 3 NICU was associated with earlier initiation of enteral feeds and HMF, and less medically complicated NICU hospital stays in preterm infants. These findings further demonstrate that adopting a standardized approach to feeding in the NICU can positively impact the nutrition and health of this high-risk population.
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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 | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
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".