Abstract 1702

Nutrition support for premature infants is challenging because of inadequate knowledge, and wide variation in clinical practice. The additive effect of critical illness further complicates feeding decisions in this population. Clinical practice guidelines (CPGs) provide a strategy to study feeding practices in premature infants, as they are evidence-based and may limit variation in practice. Objective: To describe feeding practices and clinical outcomes for premature infants < 1500 grams prior to implementation of CPGs. Method: Chart reviews were conducted for all appropriate for gestational age infants < 1500 grams admitted to NICU who had no major anomalies affecting feeding practices. Prenatal history, mode of delivery, clinical status of the infant, and variables related to feeding were collected. Data collection began on the day of admission and continued for 48 hours after tolerance of full feeds or discharge from hospital. Results: The analysis indicates variability in outcomes. (Table) Differences in practice including timing of first feed, management of feeding intolerance, and clinical status of the infant, may explain the variability noted. Multiple linear regression analysis demonstrated the number of days feeds were interrupted for ≥3 feeds per day, gestational age, and cisapride use were significant predictors for days to full feeds (F(3,71)=94.10, p=0.0001). The model explained 80% of the variance in days to full feeds. Conclusion: Wide variation in feeding practices was found on initial analysis, suggesting that implementation of CPGs may improve quality of care and reduce hospital stay in premature infants < 1500 grams.

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