Neonatal Nutrition Initiative
Postnatal nutritional deficit in Very Low Birth Weight (VLBW) infants is associated with developmental delay and adult morbidities. Hospital teams participating in the Neonatal Nutrition Initiative work to reduce the number of VLBW babies discharged with body weight less than the 10th percentile by increasing their growth after birth through evidence-based feeding protocols. These protocols have been shown to optimize the growth of VLBW infants and improve long-term health outcomes for these at-risk infants.
As compared with the intrauterine growth of normal term infants, the growth of prematurely born infants is typically delayed. Approximately 90% of VLBW infants fall in the category of extra-uterine growth restriction by 36 weeks post-conceptional age. Poor nutrition is a significant contributory factor and is associated with prolonged hospitalization and an increased risk for poor health outcomes.
The goal of this initiative is to improve the nutritional status of premature infants, particularly VLBW, by instituting early enteral feeding and TPN (total parenteral nutrition) supplementation when indicated. By standardizing the method of early nutrition with increased use of breast milk, appropriate use of TPN together with closely monitoring the growth parameters (weight, length, head circumference) at each NICU, we will try to achieve improvement in the growth pattern, therefore diminishing the number of extra-uterine growth restricted infants in Illinois.
Download the Nutrition Initiative factsheet»
Golden Hour Initiative
Clinical interventions for resuscitation and stabilization in the first 90 minutes of life affect infant outcomes. Hospital teams participating in the Golden Hour Initiative work to improve outcomes of infants requiring resuscitation and stabilization by implementing evidenced-based practices for the first hours of life.
Appropriate fetal and newborn interventions at the time of delivery and immediately after delivery are critical to improve the outcomes and applicable to neonates of all gestational ages. Those interventions include delayed cord clamping, thermoregulation and oxygenation and require well-coordinated care among the services and providers, particularly within the first 90 minutes of life, referred to as the “Golden Hour.” ILPQC has successfully implemented the Very Low Birth Weight (VLBW) hypothermia project and has sustained the effect of this initiative since 2009. ILPQC’s past experience ensure the success of the Golden Hour initiative.
The Neonatal Advisory Group has developed protocols and toolkits for implementation in Illinois birthing hospitals that will be rolled-out at the April 20, 2015 kick-off in Naperville.
Neonatal Golden Hour Toolkit Planning Meetings
Held the 2nd and 4th Wednesday of the month
For more information, please contact firstname.lastname@example.org.
Akihiko Noguchi, MD, MPH
Professor of Pediatrics, Cardinal Glennon Children’s Medical Center, Saint Louis University
Patricia Ittmann, DO
Neonatologist, Quality Leader, Rockford Health System
Adapted for ILPQC from Vermont Oxford NICQ 2009