Published online Aug 8, 2016. doi: 10.5409/wjcp.v5.i3.325
Peer-review started: January 20, 2016
First decision: April 18, 2016
Revised: May 8, 2016
Accepted: June 27, 2016
Article in press: June 29, 2016
Published online: August 8, 2016
AIM: To ascertain United Kingdom adherence to European society of Paediatric Gastroenterology, Hepatology and Nutrition guidance (ESPGHAN).
METHODS: A national cross sectional questionnaire study of neonatal units across England was completed between January and March 2014. All 174 units in the country were attempted to be contacted to complete a telephone survey. This included all level 1, 2 and 3 units. They were initially contacted by phone and asking any senior member of the team about their current practice and procedures. The first ten telephone interviews were completed with two researchers present to ensure consistency of approach. If no response was received or no details were available, one further attempt was made to contact the unit. The results were recorded in a proforma and then collated and entered into a spreadsheet for analysis. Comparison to United Kingdom adherence to ESPGHAN guidance was completed.
RESULTS: Response rate was 53%. There was variation in use of all supplements. The survey collected data from 91 neonatal units (53% response rate). It was found that 10% of neonatal units had no fixed policy on supplements. The protocols regarding supplementation involved predominantly folic acid, vitamin A, vitamin D and iron, with much variation in doses and regimens. The criteria for prescribing supplements was largely based on age (47%) with only 7% using a weight targets to initiate supplements. Summary data regarding the appropriateness of each nutritional supplement for a variety of different weights are presented, as well as comparison to ESPGHAN guidance which suggests issues with both underdoing of Breast Fed infants and overdosing of infants on several artificial formulas which already contain significant amounts of these nutritional elements.
CONCLUSION: There is significant heterogeneity in neonatal policies when prescribing supplements to neonates. National policies which take international guidance into account are recommended.
Core tip: Nutritional supplementation in neonates is common in neonatal units, but there is no clear United Kingdom guidance. This study set out to ascertain United Kingdom practice with a national cross-sectional study with reference to European society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) nutritional guidance. Fifty-five percent of the 174 units in the country were contacted. There was variation in use of all supplements. Comparison to ESPGHAN guidance suggests issues with both underdoing of Breast Fed infants and overdosing of preterm infants on several artificial formulas which already contain significant amounts of nutritional elements. National policies which take international guidance into account are recommended, with similar research needed in other countries.