Nutrition practices of neonatal intensive care units in the African Neonatal Network
Keywords:
Infant, Premature; Infant, Newborn; Nutritional Support; Neonatal Intensive Care Units; Lactation Support; Diet, Infant; Milk, Human; Human Milk Banking; Africa South of the Sahara; Global HealthAbstract
Background: Optimal and adequate nutrition provision and standard nutritional practice is mandatory for critically ill infants in the neonatal intensive care unit. Poor nutrition in early life is associated with problems that increase risk of mortality and morbidity in preterm newborns. Preterm infants are at high risk of having inadequate nutrition in low-resource settings due to lack of resources
and trained health workers.
Methods: Fourteen hospitals in the African Neonatal Network responded to an annual facility survey and a health facility survey co-developed by faculty in the African Neonatal Network and Vermont Oxford Network. All analyses use descriptive statistics.
Results: Almost all the units (94%) had guidelines for initiation and advancement of feeding. Ten hospitals (71%) reported complying with Baby-Friendly Hospital initiatives. Among the 14 hospitals, only one (7%) had access to pasteurized donor milk. There was
significant variation in use of breast milk fortifiers; only three (21%) hospitals reported using it consistently for more than 90% of
their preterm newborns. There was also variation in human resources related to neonatal NICU nutrition with only four (29%) of the hospitals having a dedicated dietitian and one with 24/7 access to a lactation consultant.
Conclusion: Dedicated dietitian or lactation support team were limited in the network hospitals. There was only one hospital with access to pasteurized donor milk, and use of breast milk fortifiers was not optimal. Optimising nutrition should be prioritised to improve opportunities for infants to go home meeting growth standards.
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