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DETERMINATION OF OUTCOMES IN VLBW NEONATES GETTING VOLUME ADVANCEMENT & FREQUENCY ADVANCEMENT PROTOCOLS OF FEEDING

Dr Muhammad Hamza Khurshid, Dr. Ali Raza, Dr Sidra Ahsan Shah

Objective: This research work aimed to find out the results of VLBW (Very Low Birth Weight) neonates obtaining frequency advancement (FA) and volume advancement (VA) protocols of feeding. Methodology: This research work carried out in the Children Hospital, Multan in a duration of six months from March 2019 to October 2019. VLBW newborns present with weight of less than 1500 grams at birth time were the part of this research work. Protocol for group of FA was to give one ml/kg human or pre-formula milk after eight hours and group of VA after every three hours in the initial stage. After the completion of 3 days, in the group of FA, we decreased the feeds duration from eight to two hours and volume of feed of ten ml.kg-1.day-1 until the dose of feeding was according to full-recommendation as 150.0 ml.kg-1.day-1 touched. Whereas in the group of VA, we gave volume of 20.0 ml.kg-1.day-1 until it touch the value which was full-recommended. The main primary outcome of the research work were the total days to achieve full feed, gain of weight and total duration of the stay in hospital. Results: Baseline neonatal weight was 1148 ± 111 grams in the group of VA and 1179 ± 106 grams in the group of FA (p-value 0.180). In the group of VA, we achieved the full feed in 11.040 ± 2.38 days versus 15.760 ± 2.48 days in the group of FA (P-value < 0.0010). The total durations of IV fluid treatment were 13.50 ± 8.40 days in the group of FA versus 9.40 ± 7.60 in the group of VA (p-value < 0.0010). Moreover, the gain of weight at the end of the protocol of feeding was much high in the group of VA as 1440.0 ± 78.0 grams versus 1284.0 ± 99.0 grams in the group of FA (P-value < 0.0010). There was occurrence of necrotizing enterocolitis in one single patient that was in the group of VA. Conclusion: VA feeding is much better in comparison with the FA feeding in VLBW neonates. Keywords: VLBW< protocol, VA, FA, methodology, occurrence, feeding, per-formula, IV fluid treatment.

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