Appendix 3 - nutrition requirements
NHS Lothian neonatal guidelines (in development)
Table 2.0 Summary of ESPGHAN 2018 Vs NICE 2020 Parenteral requirements for PRETERM infants
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Preterm PN requirements |
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NICE 2020 |
ESPGHAN 2018 |
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Energy Kcal/kg/day |
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Starting dose |
40 – 60 |
45 – 55 |
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Starting dose if > 4 days after birth |
75 – 120 |
- |
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Maintenance dose |
75 – 120 (Gradually increase e.g., over 4 days) |
90- 120 (Increase gradually) |
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Amino acids g/kg/day (Protein g/kg/day) |
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Starting dose |
1.5 – 2 (1.35 – 1.8)
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1.5 minimum (1.35) |
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Starting dose if > 4 days after birth |
3.0 – 4.0 (2.7 – 3.6)
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- |
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Maintenance dose |
3.0 -4.0 (2.7 – 3.6) (Gradually increase e.g., over 4 days) |
2.5 -3.0 (2.25 – 3.15) (Gradually increase) |
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Glucose g/kg/day |
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Starting dose |
6-9 |
5.8 – 11.5
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Starting dose if > 4 days after birth |
9 – 16 |
- |
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Maintenance dose |
9-16 Gradually increase (e.g., over 4 days) |
11.5 – 14.4 (Min 5.8 and max 17.3) |
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Fat (g/kg/day) |
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Starting dose |
1.0 -2.0
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Not specified
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Starting dose if > 4 days after birth |
2.5 – 3.0
|
- |
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Maintenance dose |
3.0 - 4.0 (Gradually increase to this e.g., in increments of 0.5 – 1.0) |
4.0 max |
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Calcium (mmol/l/day) |
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Starting dose |
0.8 – 1.0 (If starting PN in the first 48 hours after birth)
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0.8 – 1.0
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Maintenance dose |
Increase to 1.5 – 2.0 after 48 hours |
1.6 – 3.5 |
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Phosphate (mmol/l/day) |
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Starting dose |
1.0 (If starting PN in the first 48 hours after birth) |
1.0 – 2.0 |
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Maintenance dose |
Increase to 2.0 after 48 hours if starting at 1.0 |
1.6 – 3.5 |
Table 3.0: Summary of ESPGHAN 2018 Vs NICE 2020 Parenteral requirements for TERM infants
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|
TERM PN requirements |
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|
|
NICE 2020 |
ESPGHAN 2018 |
|
Energy Kcal/kg/day |
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|
Starting dose |
40 – 60 |
45 – 50 |
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Starting dose if > 4 days after birth |
75 – 120 |
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|
Maintenance dose |
75 – 120 (Gradually increase e.g., over 4 days) |
75 – 85 |
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Amino acids g/kg/day (Protein g/kg/day) |
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|
Starting dose |
1-2 (0.9 – 1.8) |
1.5 (1.35) |
|
Starting dose if > 4 days after birth |
2.5 – 3 (2.25 – 2.7) |
- |
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Maintenance dose |
2.5 -3.0 (2.25 – 2,7) (Gradually increase e.g., over 4 days) |
1.5 – 3.0 (1.35 – 2.7)- NEWBORN 1.0 – 2.5 (0.9 – 2.25) - (1mth–3yrs) |
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Glucose g/kg/day |
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Starting dose |
6-9 |
3.6 – 7.2 |
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Starting dose if > 4 days after birth |
9 – 16 |
- |
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Maintenance dose |
9-16 Gradually increase (e.g., over 4 days) |
8.6 – 14 |
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Fat g/kg/day |
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Starting dose |
1.0 -2.0
|
Not specified |
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Starting dose if > 4 days after birth |
2.5 – 3.0
|
- |
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Maintenance dose |
3.0 - 4.0 (Gradually increase to this e.g., in increments of 0.5 – 1g/kg/day) |
Max 4.0 |
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Calcium mmol/l/day (0- 6 months) |
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Starting dose |
0.8 – 1.0 (If starting PN in the first 48 hours after birth) |
- |
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Maintenance dose |
Increase to 1.5 – 2.0 after 48 hours |
0.8 – 1.5 |
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Phosphate mmol/l/day (0- 6 months) |
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Starting dose |
1.0 (If starting PN in the first 48 hours after birth) |
- |
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Maintenance dose |
Increase to 2.0 after 48 hours if starting at 1.0 |
0.7 – 1.3 |