Enteral nutrition practices among very preterm infants in neonatal units: a cross-country comparative study
Abstract
Purpose
The objective of this study was to delineate and compare enteral nutrition (EN) practices among neonatal units across the Arabian Gulf countries.
Design/methodology/approach
A cross-sectional study was conducted by recruiting 255 clinicians working in neonatal units in the Arabian Gulf countries.
Findings
Out of 255 invited clinicians, 73 (29%) participated in the survey. Neonatal units used varied EN strategies, where feeding practices exhibited variability. The majority (74%) of units had a local standard feeding protocol, while 18% followed international protocols, and 8% did not adhere to a specific protocol. When maternal milk was not used, the main alternatives were preterm formula (67%) and predigested formula (14%). The age at which the first EN was commenced and the reported advancement rate showed significant variations among different units (p < 0.001). The initiation of fortification was primarily driven by reaching a specific enteral volume (commonly reported as 100 mL/kg/day) and addressing poor postnatal growth. Fortification practices did not differ significantly among professions, except for the initial fortification strength, where none of the dietitians and only 8.3% of neonatologists preferred full strength, compared to 28.6% and 21.4% of medical residents and nurses, respectively (p = 0.033).
Originality/value
This study marks the first exploration of EN practices in neonatal units, examining their local and cross-country variations. It provides valuable insights to guide local trials and foster global collaboration among neonatal units to establish a unified knowledge base, standardized practices and promote research and innovation, ultimately contributing to optimal feeding practices for very preterm infants.
Keywords
Acknowledgements
Declarations:
Funding: The authors received no financial support for the research, authorship and/or publication of this article.
Conflict of interest: The choice of topic and the views expressed are solely those of the authors. The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. The lead author affirms that this manuscript is an honest, accurate and transparent account of the study being reported. The reporting of this work is compliant with the strengthening the reporting of observational studies in epidemiology (STROBE) guidelines. The lead author affirms that no important aspects of the study have been omitted and that any discrepancies from the study as planned have been explained.
Availability of data and material: The datasets analyzed during the current study are available from the corresponding author on reasonable request.
Authorship contributions: W.A.: conceptualization/design, supervision, writing – reviewing and editing. R.A., N.A., B.A.-Z. and M.A.: conceptualization/design, methodology, data curation, investigation, writing – original draft preparation. J.A., H.A. and H.A.: investigation, writing – original draft preparation. T.S.: conceptualization/design, validation, formal analysis. R.K.: investigation, writing – reviewing and editing. All authors approved the final version sharing the responsibility for ensuring that the manuscript complies with the journal style requirements and terms of consideration.
Citation
Alyahya, W., AlSharfa, R., Alduhbaki, N., Al-Zahir, B., Alqalaf, M., Alawfi, J., Altwejri, H., Alessa, H., Purayidathil, T. and Khattab, R. (2024), "Enteral nutrition practices among very preterm infants in neonatal units: a cross-country comparative study", Nutrition & Food Science, Vol. ahead-of-print No. ahead-of-print. https://doi.org/10.1108/NFS-02-2024-0045
Publisher
:Emerald Publishing Limited
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