Growth on a Level 2 Neonatal Unit

Mid Yorkshire Neonatal unit is a level 2 unit that admits infants above 800g, 27 week singletons or 28 week multiple births. Growth is reviewed weekly with weekly head circumferences and twice weekly weights.There is a Yorkshire and Humber Neonatal Feeding guideline for the preterm infant, stating preterm infants should be gaining 15-20g/kg/day. Growth was reviewed to see if achieving recommended growth.

Methods: Collected data on all infants inpatients more than 14 days from January 2018 to March 2018. Notes and Badger was used. Documented time to first feeds, to full feed, if received EBM. Birth and discharge weights and head circumferences were recorded.

Results: In total 39 infants with 4 term and 35 pre term. Average length of stay was 35 days. At discharge 37% of preterm infants had a weight gain of 15-20g/kg/day, 40% had a weight gain of 10-15g/kg/day. 17% had weight gain less than 10g/kg/day and 6% lost weight. For term infants 50% lost weight, 25% gained weight and 25% had static weight.

69% had maximum feed of 150mls/kg/day. Average time to first feeds was 1.8 days, and 6.5 days to full feeds. 44% discharged receiving EBM. 100% had birth weight recorded and 67% birth head circumferences. There were 100% of discharge weights and 77% of discharge head circumferences documented. 54% dropped more than 2 centiles in weight, and 9% dropped 2 head circumference centiles.

Conclusion: Despite the small sample size and missing data from notes and badger, it gives an indication of the growth. 87% gained weight by discharge, with 33% achieving recommended growth. A feeding pro forma sheet was created. The unit is being re-audited after several months of using these sheets to see if there has been any change in in documentation, impact on growth and therefore length of admission.