SSM Health Medical Minute – Cardinal Glennon expert explains trophic feeding for NICU babies

Medical Minute

ST. LOUIS – Feeding very low birth weight or very preterm infants poses a unique challenge due to the immaturity of the gastrointestinal tract. Every nutrition is crucial for improving optimal growth, long-term outcomes, and decrease morbidities. The goal is to achieve a growth rate similar to fetal growth in utero. 

Trophic feedings, also called “minimal” or “priming” enteral feedings, are beneficial for preterm, low birth weight, or NICU infants. It is a small volume of balance enteral nutrition to help preemies stimulate their gut and begin to absorb the nutrients they need to thrive and grow. 

Trophic feedings are teeny tiny volumes of nutrition given to babies starting soon after birth aimed at preventing atrophy of the gut. These feedings are traditionally given in small amounts of 1-3 ml per feeding, every 1-3 hours.

Traditionally, trophic feedings were given via IV nutrition, a mixture of sugar, fat, protein, and calories, but Dr. Catherine Cibulskis, a SLUCare neonatologist at SSM Health Cardinal Glennon Children’s Hospital, says breast milk is best, even if the breast milk is donated. 

If breast milk is unavailable, preemie formula can be used.

“For a lot of our moms, the first day or two after delivery, moms may not have an adequate breast milk supply. We do use donor breast milk if mom is unable to produce,” Cibulskis said. “The donor milk is from moms who have full-term healthy babies and produce a lot of milk. The mothers are all tested, the milk is all tested and it is pasteurized to make sure that it is safe for our babies. We know this milk is better tolerated by the babies instead of formula.” 

Trophic feedings of breast milk is advanced slowly until the infant respiratory and cardiac status have stabilized and intestinal motility is stable as well. 

“All of our babies who are born prematurely start at a reduced feeding volume, typically, for babies under 1500 grams, or about 3-3.5 pounds,” Cibulskis said. “Babies who are born at that weight are at highest risk for complications.”

Even babies who are over 3 pounds at birth can be eligible for trophic feeding.

“There are also other babies with impaired blood flow or impaired oxygenation in their gut, heart disease, lower oxygen levels going to their intestines,” Cibulskis said. “Any babies who have some reason to have surgery on their belly may also need trophic feedings.”

To find out more about Cardinal Glennon neonatal care unit, click here.

The SSM Health Medical Minute airs Wednesdays on News 11 at 7pm and FOX 2 News at 9pm.

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