Aung myo zaw(nutrition in preterm and congenital hypotrophy)

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Aung myo zaw(nutrition in preterm and congenital hypotrophy)

  1. 1. Nutrition in Preterm and Congenital hypotrophy <ul><li>Presented by : Dr. Aung Myo Zaw </li></ul><ul><li>Supervised by : Dr. A.N Goraynova </li></ul>
  2. 2. Causes of Preterm and Congenital Hypotrophy <ul><li>Maternal factors </li></ul><ul><li>Maternal infection </li></ul><ul><li>Hypertension </li></ul><ul><li>Diabetes </li></ul><ul><li>Malnutrition, Anemia </li></ul><ul><li>Alcohol, drugs </li></ul><ul><li>Cigarette smoking </li></ul><ul><li>Placenta previa, </li></ul><ul><li>Placenta abruption </li></ul><ul><li>Fetal factors </li></ul><ul><li>Multiple pregnancy </li></ul><ul><li>Congenital malformation </li></ul><ul><li>Infection </li></ul><ul><li>Fetal Hypoxia, Fetal distress </li></ul><ul><li>Rh incompatible </li></ul><ul><li>Intrauterine growth retardation </li></ul>
  3. 3. Introduction <ul><li>Premature infants have greater nutritional needs to achieve optimal growth in the neonatal period than at any other time of their life </li></ul><ul><li>Corrects growth restriction at birth and achieves appropriate rates of weight gain </li></ul>
  4. 4. Pathophysiology of no entral feeding <ul><li>Gut atrophy, </li></ul><ul><li>Luminal starvation, </li></ul><ul><li>Bacterial translocation, </li></ul><ul><li>Impaired immune function </li></ul>
  5. 5. Advantage of Early Minimal Entral Feeding <ul><li>Faster weight gain </li></ul><ul><li>Less feeding intolerance </li></ul><ul><li>Less need for phototherapy, </li></ul><ul><li>Enhanced serum gastrin concentrations </li></ul><ul><li>Enhanced maturation of the small intestine function, </li></ul><ul><li>Lower bilirubin concentrations </li></ul><ul><li>Shorter duration of hospitalization </li></ul><ul><li>Not increase the incidence of necrotizing enterocolitis </li></ul>
  6. 6. Comparison of Breast milk and Preterm formula <ul><li>Breast milk </li></ul><ul><li>Soft, easily-digestible whey </li></ul><ul><li>Rich lactose, </li></ul><ul><li>oligosaccharides, which promote intestinal health </li></ul><ul><li>Lactoferrin, Lysozyme, </li></ul><ul><li>sIgA </li></ul><ul><li>Preterm formula </li></ul><ul><li>More energy, protein, </li></ul><ul><li>Ca ++, Ph, Mg, vitamins </li></ul><ul><li>Lacks of antibodies and other substrates </li></ul>
  7. 7. Contraindications to Entral Feeding <ul><ul><li>Assessment of the newborn by the Apgar’s score below 7 points in severe neonatal asphyxia </li></ul></ul><ul><ul><li>Birth trauma </li></ul></ul><ul><ul><li>Convulsions </li></ul></ul><ul><ul><li>Respiratory distress syndrome, as well as profound prematurity </li></ul></ul><ul><ul><li>Severe developmental defects (gastro-intestinal tract, oral facial organs, heart, etc.) </li></ul></ul>
  8. 8. Aim of study <ul><li>To assess the effectiveness of nutrition in Preterm and Congenital hypotrophy </li></ul>
  9. 9. Patients and methods <ul><li>Retrospective study </li></ul><ul><li>30 newborns in Neonatal department and Neonatal Intensive care unit in Thushinskaya Children’s Hospital from January to May,2007 </li></ul>
  10. 11. Difference Between Preterm and Term newborns 20 Difference between Preterm and Term Preterm(<37 week) 83.33%
  11. 12. Birth weight in Preterm and Congenital Hypotrophy
  12. 13. Birth weight(<2.5kg)
  13. 15. Mother’s has disease or not <ul><li>Disease(+) -23(76.67%) </li></ul><ul><li>Intrauterine infection -15 (50%) </li></ul><ul><li>Others conditions -8 (26.67%) </li></ul><ul><li>No disease -7(23.33%) </li></ul>
  14. 16. Intrauterine infection (n=15)
  15. 17. Other conditions(n=8)
  16. 19. Newborn’s numbers in Intensive Care Unit
  17. 20. Types of nutrition used in Intensive Care Unit 3.33%
  18. 21. Volumes of nutrition giving in Intensive Care Unit(Preterm)
  19. 22. Changes in body weight in Intensive Care Unit (Preterm)
  20. 23. Types of nutrition used in Neonatal Department
  21. 24. Body weight changes in different forms of nutrition(g/day) 31.1 Results
  22. 25. Conclusion <ul><li>Preterm and Congenital hypotrophy are typical problems </li></ul><ul><li>Preterm formula plus breast feeding is most effective for preterm and small for gestational age </li></ul><ul><li>But if breast milk is unable to feed , preterm formula is most preferred for preterm newborn and congenital hypotrophy </li></ul>

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