The late preterm infant is described as being born between 340 weeks through 366 weeks gestation. Cne establishing breastfeeding with the late continuing nursing education cne credit a total of 1. Five things parents of a late preterm nearterm infant should know and watch for. What parents of late preterm nearterm infants need to know. Guidelines for the use of human milkinfant formula in preterm infants protocol for gut priming in preterm infants. However, research has shown that they often have some of the same medical issues as early preterm infants, including. Most cases were later attributed to consumption of a chloridedeficient soy infant formula. Patient presentation a 19 day old, former 35 17 week late preterm male infant came to clinic for his first appointment after he was discharged from the neonatal intensive care unit. This is because children born preterm have been managed as if they had been born at term for many years. These infants are referred to as late preterm infants lpi. They have higher morbidity and mortality rates than term infants gestational age. Benefits of human milk in preterm infant feeding feeding choice for every infant 6. Nipple feedings can be considered as the infant matures. Supplementation in preterm and late preterm infants after.
Late preterm babies dont have as much body fat to keep their temperature normal. Multidisciplinary guidelines for the care of late preterm. Late preterm infants are defined as infants born between 34 completed weeks and 36 weeks and 6 days of gestation. Breastfeeding the late preterm infant marsha walker correspondence marsha walker, rn, ibclc, 254 conant road, weston, ma 02493. Current standards are summarized in the electronic code of federal regulations.
Treatment for jaundice in a late preterm infant is sometimes started during the first few days of. Supplementation with formula results in a rapid shift in the gut bacterial profile of a breastfed infant. Nutrition practice care guidelines for preterm infants in. In addition, a late preterm infant may not be able to take in as much breastmilk or formula as a fullterm infant. Continued on back side what every parent should know a late preterm infant is a baby born 3 to 6 weeks early. Nutrition practice care guidelines for preterm infants in the.
Nutritional recommendations for the latepreterm infant and the. Now with integrated gestational age calculator and decision support e. Late preterm infants are born at a gestational age ga between 34 weeks and 0 days, and 36 weeks and 6 days. Thus, they are at higher risk of morbidity and mortality than term infants. All late preterm infants, especially those born less than 2000 grams, should be closely monitored for growth adequacy, with a low threshold for supplemental feedings of preterm or postdischarge infant formula if suboptimal growth is noted. With the production of multidisciplinary guidelines for the care of late preterm. Awhonn is accredited as a provider of continuing nursing. Latepreterm infants are physiologically and metabolically immature. Treatment for jaundice in a late preterm infant is sometimes started during the first few days of life while the infant is still in the hospital. Late preterm lpt infants are at risk for feeding dif. Oct 09, 2014 preterm birth interrupts physiological foetal development, leading to various degrees of immaturity according to the gestational age at which the infant is born.
In a later study, growth and development of preterm vlbw infants were measured in groups that received predominantly human milk, predominantly preterm. The infant formula act of 1980 and its amendments in 1986 defined minimum concentrations of 29 nutrients and established quality control standards for commercial production of infant formulas. Late preterm babies born at 34, 35 or 36 weeks of pregnancy are. Preterm formulas can be used for supplementation of breastmilk or as a breastmilk substitute but there is little evidence for their use in the late preterm infant. Council of international neonatal nursing coinn position. Vaucher, and the academy of breastfeeding medicine a central goal of the academy of breastfeeding medicine is the development of clinical protocols for managing.
The united nations millennium development goal mdg 4 1 calls for a 23rd reduction in under five years of age mortality. But this evidence was not strong enough to recommend fortification of hm after discharge 105, 106. Consensusclinicalguidelinesfor late preterm infant lpi. Head off complications in late preterm infants mdedge. For bottle fed infants, offer feeding at least every 3 hours. For all late preterm infants have mother manually expresspump. Identify the late preterm infant as atrisk for rehospitalization within the first 2 weeks of life. A sample care plan for late preterm infants gestational age 34 07 wks to 36 67 wks challenges desired outcomes shortlong interventions outcomes met. Multidisciplinary guidelines for the care of late preterm infants. Gestational or preexisting diabetes mellitus, pregnancyinduced hypertension, maternalobesity, tocolytic use for preterm labor, late antepartumintrapartum. Late preterm infant mortality is higher than that for. Overview of late preterm infant health verywell family. Strengthening nicu healthcare professionals knowledge.
A latepreterm infant is a baby born three to six weeks early, or between 34 and 36 completed weeks of gestation. Caring for the late preterm infant a clinical practice guideline late preterm infants, those born between 34 07 weeks and 36 67 weeks, often appear outwardly similar to and are treated like full term infants. Consider additional glucose checks beyond 24 hours if the protocol values were. Since 2005, the imprecise definition of nearterm infants has been replaced with latepreterm, which includes infants born between 3407.
Between 1990 and 2006, there was a dramatic 25% increase in the rate of late preterm infants in the united states, although more recently this number has leveled off. Late preterm infants are infants born at a gestational age between 34 0. Young,2 and the academy of breastfeeding medicine a central goal of the academy of breastfeeding medicine is the development of clinical protocols, free from. Recent studies show that these latepreterm infants are at greater risk for potentially serious health problems than fullterm newborns. Late preterm has replaced near term to describe this group of infants, since near term incorrectly implies that these infants are almost term and only require routine neonatal care. How long do late preterm infants need supplemental. Degree of prematurity, bilirubin level, and other medical conditions. Uses the 20 fenton growth charts to report percentiles and zscores. Probiotics and prebiotics use in preterm infants chapter 7. Formula feeding for latepreterm infants article pdf available in italian journal of pediatrics 40suppl 2.
Identify three nutritional interventions for the late preterm infant. In 2005, the american academy of pediatrics and the american college of obstetricians and gynecologists held an expert panel meeting. Care plan for late preterm infants gestational age 34 07. Formulas for preterm infants were developed with a nutrient profile different from that of human milk and term formulas, in part because of early observations that preterm infants grew better when formula, human milk, or banked human milk was supplemented with protein and minerals atkinson et al. Life sciences research office 9650 rockville pike bethesda, maryland 20814 prepared for the center for food safety and applied nutrition, food and drug administration, department of health and human services, washington, dc 20204 under fda contract no.
Most late preterm infants who require a nipple shield for initial feeding are able to outgrow their need for it at approximately 2 to 4 weeks after their due date. A late preterm birth happens between 34 and almost 37 weeks of pregnancy. Postdischarge preterm formula alberta health services. Consensusclinicalguidelinesforlatepreterminfantlpi.
Nutrient requirements for preterm infant formulas editor. Late preterm infants have unique, often unrecognized, vulnerabilities that predispose them to high rates of nutritionally related morbidity and hospital readmissions. Nov, 2017 a 19 day old, former 35 17 week late preterm male infant came to clinic for his first appointment after he was discharged from the neonatal intensive care unit. Late preterm infants tend to feed slower and may need to be fed more often than fullterm babies. Infant will be seen by physicain withing 2448 hours of discharge. Feeding difficulties are common and some infants require intravenous nutritional support soon after birth.
However, in order to meet the unique nutritional requirements of preterm infants and preserve the singular benefit of breastfeeding, human milk should be fortified to allow adequate growth and bone mineralization 9. Complications are common with late preterm infants, which refers to babies born between 34 weeks 0 days and 36 weeks 6 days of pregnancy. Feeding your preterm infant stepbystep constipation in the preterm infant probiotic use in preterm infants table 6. Mar, 2020 late preterm babies get tired easily and may not be strong enough feeders to drink enough breast milk or formula to gain weight. Late preterm infants are physiologically and metabolically immature. Breastfeeding the late preterm academy of breastfeeding.
Special considerations for late preterm infants72 medical risks for the late preterm infants feeding the late preterm infant. Preterm formula use in the preterm very low birth weight infant. Outcomes of implementation of a nicubased late preterm. Followup recommendations for the late preterm infant. Late preterm infants shown to be at higher risk of hypoglycemia and hypothermia in 1st 12 hrs of life lp infants also shown to have slower lung fluid clearance, less surfactant compared to ft infants there is 2x relative risk of sudden infant death syndrome for lp infants 1. Transitioning the breastfeeding preterm infant from the neonatal intensive care unit to home, revised 2018 lawrence m. Much of the neonatal nutrition literature has focused on the manage ment of very low birth weight infants, a group of infants usually less than. Since 2005, the imprecise definition of nearterm infants has been replaced with latepreterm, which includes infants born between 34 07 and 36 67 weeks of gestation.
Explain the physiologic reasons that a late preterm infant may breastfeed poorly. Babies born just a few weeks early have special needs that will be closely watched by the nurses and doctors caring for your baby. Only limited data from controlled trials are available. Latepreterm infants, defined by birth at 34 through 36 weeks gestation, are less physiologically and metabolically mature than term infants.
Establishing breastfeeding with the late preterm infant in. The purpose of this report is to define late preterm, recommend a change in terminology from near term to late. Lopera, mph, wenyang mao, mph,b marcy mcmahon, rn, ibclc, barbara l. Breastfeeding the late preterm 3436 67 weeks of gestation and early term infants 3738 67 weeks of gestation, second revision 2016 eyla g. Late preterm infants, early term infants, and timing of. However, supplementation of breastmilk may be indicated to promote optimal growth. In 2005, latepreterm births accounted for more than 70% of all preterm births coinn position statement on care of the late preterm infant coinn position. This booklet will help you learn to breastfeed andor feed breast milk to your late preterm baby. Educate the mother about breastfeeding her late preterm infant e.
Breast milk preterm breast milk is 290 mosml or formula for preterm infants e. Assessment and care of the late preterm infant national perinatal association multidisciplinary guidelines for the care of late preterm infants 36 week work group 2018 monthly meetings continued as we worked on practice changes we wanted to implement disposable thermometers trial glucose gel approved on formulary. Patrica gutweiler, rn, ibclc assisted with the writing of this chapter. Research article outcomes of implementation of a nicubased late preterm infant feeding guideline laura a. If after 10 minutes of manual expression, no milk obtained, feed infant formula by alternate feeding method. Special considerations for late preterm infants 72 medical risks for the late preterm infants. The best judge of when to start nipple feedings is an experienced nurse. May 01, 2011 the infant formula act of 1980 and its amendments in 1986 defined minimum concentrations of 29 nutrients and established quality control standards for commercial production of infant formulas. Upon discharge from hospital preterm infants may require fortification of. A37a37 october 2014 with 51 reads how we measure reads. How long do late preterm infants need supplemental feedings. Consensusclinicalguidelinesforlatepreterminfantlpifeeding. Preterm birth interrupts physiological foetal development, leading to various degrees of immaturity according to the gestational age at which the infant is born.