|
“When you know your WHY, your WHAT has more impact because you’re walking in or towards your purpose.” - Michael Jr.
Regardless of where you are in your journey through the Care of the Late Preterm Infant initiative, it is always worthwhile to consider why we are doing this work. A recent commentary titled “Moderate and Late Preterm infants deserve more attention”
A few important points summarized by the author include:
• moderate and late preterm infants (ie., 32 - < 37 weeks post menstrual age) represent the most common preterm population
• most preterm infants born after 32 weeks will nearly approximate the weight and length of more mature infants with absent or transient symptoms betraying their immaturity
• much of this population may never visit a NICU or have a brief NICU stay
• as such, this population misses out on the benefits of dedicated guidelines and best practices that are a staple of care for more preterm infants
• the relative lack of protocols for older preterm infants means their unique needs may go unmet and lead to considerable practice variation
The author goes on to highlight variation in practices around enteral feeding, citing statistics that in a survey of neonatologists and pediatricians, 40% would initiate enteral feeds with formula for a healthy late preterm infant, and 15% would do the same for a moderate preterm infant while waiting for the availability of mother’s milk. Only a small percentage, 10%, would initiate feeding with donor human milk.
Guidelines for the care and feeding of late preterm infants are strongly needed to reduce practice variation and improve patient outcomes. If you have not yet considered adopting practice guidelines around feeding and supplementation, it is worthwhile investigating this idea further. Several facilities have developed or are in the process of adopting feeding guidelines and can share the fruits of their labor with your team. This population of infants truly does deserve more of our attention.
| 
