Avaliação de esquemas dietéticos de progressão rápida ou lenta na alimentação de recém-nascidos prematuros.

Abstract

The nutritional needs of newly born premature infants is controversial; many concepts are still under development. There are not fixed rules on when to start, what the diet volume is, how to gradually increase it and how long the intervals should be. OBJECTIVE: to assess the risks and the benefits in the introduction of fast and low progression diet schemes to newly born preterms. METHOD: a prospective randomized controlled study, carried out in the Sofia Feldman Maternity Hospital Neonatal ICU (Intensive Care Unit), in Belo Horizonte, Minas Gerais, Brazil. An evaluation was made of 101 newly born infants whose gestational ages were = 34 weeks, weighing between 700 and 2410 grams, randomly assigned to either the fast progression diet group, n = 52, or the slow progression diet group, control group, n = 49. RESULTS: divided into 2 groups, 101 preterms were evaluated, with 52 subjects in the intervention group and the other 49 in the control group. In order to reach the complete diet of 180 ml/Kg/day in the intervention group, less time was necessary (8/13 days, median) and less consume of antibiotics, with statistically significant difference (p = 0,01). For this group, there was lower incidence of late sepsis (p = 0,02). There were 11 unsuccessful cases in the control group and 6 in the intervention group, presenting no statistically significant differences between the two schemes. Incidence of necrosing enterocolitis reached 8.1% in scheme I and 3.8% in scheme II without statistic difference. 7 newly-born infants died 4 in scheme I and 3 in scheme II. CONCLUSION: newly born premature infants can tolerate fast diet increase without elevation in risk of side adverse effects. In this study, a fast diet increase coincided with lowerincidence of late sepsis, thus decreasing morbidity in the infants involved.