Appendix 5 - nutritional content of example PN prescription volumes for TERM INFANTS
NHS Lothian neonatal guidelines (in development)
Table 8.0: Nutritional Content Vs requirements for TERM INFANTS (First month of life):
using 12.5% bag given at standardised fluid volumes for >1500g Birth weight
|
|
NICE 2020* Starting dose Nutrition Req (Unless stated |
Day 1
|
Day 2
|
Day 3 Onwards
|
Reference to show 3.5g fat/kg + Aqueous
|
ESPGHAN 2018 Full Nutrition Require-ments (Unless stated) |
|
Aqueous vol (ml/kg) |
|
48 |
68 |
82 |
80 |
|
|
SMOF lipid solution vol ml/kg |
12 |
12 |
18 |
20 |
||
|
Total vol ml/kg |
60 |
80 |
100 |
100 |
||
|
Protein g/kg/day |
0.9 – 1.8 |
1.4 (~6 kcal/kg) |
2.0 (8 kcal/kg) |
2.4 (~10 kcal/kg) |
2.3 (~9 kcal/kg) |
1.25 - 2.5 |
|
Amino Acid g/kg/day |
1 - 2 |
1.6 |
2.4 |
2.9 |
2.8 |
1.5 – 3.0 |
|
Sodium mmol/kg/day |
0 – 2.0 ESPGHAN 2018
|
1.54 |
2.2 |
2.6 |
2.6 |
2.0 – 3.0
|
|
Potassium mmol/kg/day |
0 – 3.0 ESPGHAN 2018
|
0.63 |
0.9 |
1.1 |
1.1 |
1.5 – 3.0
|
|
Phosphate mmol/kg/day |
1.0 |
0.78 |
1.1 |
1.33 |
1.33 |
0.7 – 1.3 (0 – 6months)
|
|
Calcium mmol/kg/day |
0.8 – 1.0 |
0.78 |
1.1 |
1.33 |
1.33 |
0.8 – 1.5 (0 – 6 months) |
|
Magnesium mmol/kg/day |
0.1 – 0.2 (0 – 6 months) (No starting dose) |
0.08 |
0.12 |
0.14 |
0.14 |
0.1 – 0.2 (0 – 6 months) |
|
Glucose 12.5% g/kg/day |
6 -9 |
6.0 (24 kcal/kg) |
8.5 (34 kcal/kg) |
10.25 (41kcal/kg) |
10.25 (41kcal/kg) |
7.2 – 14.4
|
|
Fat g/kg/day |
1 - 2 |
2.0 (20kcal/kg) |
2.0 (20 kcal/kg) |
3.0 (30 kcal/kg) |
3.5 (35 kcal/kg) |
4.0 max
|
|
NON-PROTEIN energy Kcal/kg/day |
|
44 |
54 |
71 |
76 |
- |
|
Non protein energy per g Amino acid |
20 – 30 (NICE 2020) |
27.5 |
22.5 |
26 |
28 |
20 – 30 (NICE 2020) |
|
Proportion of fat energy from non-protein energy % |
25 – 40 (NICE 2020) |
45 |
37 |
42 |
46 |
25 – 40 (NICE 2020) |
|
Proportion of carbohydrate energy from non- protein energy % |
60 – 75 (NICE 2020) |
55 |
63 |
58 |
54
|
60 – 75 (NICE 2020) |
|
Total Energy Kcal/kg/day |
45 - 50 |
50 |
62 |
81 |
90 |
75 - 85 |
*ESPGHAN doesn’t set starting requirements for term
Table 9.0: Central bag - 16% Glucose bag showing ESPGHAN 2018 and NICE 2020 nutritional requirements comparison for term infants
NB Suggested standard aim of 100ml/kg/day with lipid added for TERM INFANTS
|
|
Aim for 100ml/kg 16% bag |
ESPGHAN 2018 Full Nutrition Requirements for term infant
|
NICE 2020 Full nutrition requirements for term infant |
|
Aqueous vol (ml/kg) |
80 |
|
|
|
SMOF lipid solution vol ml/kg |
20 |
||
|
Total vol ml/kg |
100 |
||
|
Protein g/kg/day |
2.5 (10kcal/kg)
|
1.25 - 2.5 |
2.2 – 2.7 |
|
Amino Acid g/kg/day |
3.0 |
1.5 – 3.0 |
2.5 – 3.0 |
|
Sodium mmol/kg/day |
3.2 |
2.0 – 3.0
|
- |
|
Potassium mmol/kg/day |
0 |
1.5 – 3.0
|
- |
|
Phosphate mmol/kg/day |
0.64 |
0.7 – 1.3 (0 – 6months)
|
2.0 |
|
Calcium mmol/kg/day |
0.64 |
0.8 – 1.5 (0 – 6 months) |
1.5 – 2.0 |
|
Magnesium mmol/kg/day |
0.16 |
0.1 – 0.2 (0 – 6 months) |
|
|
Glucose g/kg/day |
12.8 (51kcal/kg) |
7.2 – 14.4
|
9.0 – 16.0 |
|
Fat g/kg/day |
3.5 (35 kcal/kg)
|
4.0 max
|
3 – 4 |
|
NON-PROTEIN energy Kcal/kg/day |
86 kcal/kg |
- |
- |
|
Non protein energy per g Amino acid |
28.7 |
- |
20 – 30 (NICE 2020) |
|
Proportion of fat energy from non-protein energy % |
40 |
- |
25 – 40 (NICE 2020) |
|
Proportion of carbohydrate energy from non- protein energy % |
60 |
- |
60 – 75 (NICE 2020) |
|
Total Energy Kcal/kg/day |
96 |
75 - 85 |
75 – 120 |
Table 10.0: Sodium free 10% Glucose bag showing ESPGHAN 2018 and NICE 2020 nutritional requirements comparison for term infants on maximum volume
NB Suggested standard aim of 130ml/kg/day with lipid included for TERM INFANTS. Note this is a short term bag only.
|
|
Aim for 130ml/kg 10% Na free bag |
ESPGHAN 2018 Full Nutrition Requirements For term infant
|
NICE 2020 Full nutrition requirements for term infant |
|
Aqueous vol (ml/kg) |
110 |
|
|
|
SMOF lipid solution vol ml/kg |
20 |
||
|
Total vol ml/kg |
130 |
||
|
Protein g/kg/day |
2.5 (~10kcal/kg)
|
1.25 - 2.5 |
2.2 – 2.7 |
|
Amino Acid g/kg/day |
2.8 |
1.5 – 3.0 |
2.5 – 3.0 |
|
Sodium mmol/kg/day |
0 |
2.0 – 3.0
|
- |
|
Potassium mmol/kg/day |
1.8 |
1.5 – 3.0
|
- |
|
Phosphate mmol/kg/day |
0.7 |
0.7 – 1.3 (0 – 6months)
|
2.0 |
|
Calcium mmol/kg/day |
0.7 |
0.8 – 1.5 (0 – 6 months) |
1.5 – 2.0 |
|
Magnesium mmol/kg/day |
0.19 |
0.1 – 0.2 (0 – 6 months) |
|
|
Glucose g/kg/day |
11 (44kcal/kg) |
7.2 – 14.4
|
9.0 – 16.0 |
|
Fat g/kg/day |
3.5 (35 kcal/kg)
|
4.0 max
|
3 - 4 |
|
NON-PROTEIN energy Kcal/kg/day |
79 kcal/kg |
- |
- |
|
Non protein energy per g Amino acid |
28.2 |
- |
20 – 30 (NICE 2020) |
|
Proportion of fat energy from non-protein energy % |
44 |
- |
25 – 40 (NICE 2020) |
|
Proportion of carbohydrate energy from non- protein energy % |
56 |
- |
60 – 75 (NICE 2020) |
|
Total Energy Kcal/kg/day |
89 |
75 – 85 |
75 - 120 |