In this new publication the use of additional measures, mid-upper arm circumference, and mid-thigh circumference were compared with repeated measures of weight, length, and head circumference. It would be great if there was some other measure that was shown to correlate with fat-free mass, that you could simply add to weekly weight and head circumference measurement, and that could then be used to evaluate changes in nutritional practice. So what else could we do? Body composition measurements would be ideal, but all current methods require either expensive equipment or extensive manipulation of the baby, or both. When I started working at the Royal Victoria Hospital in Montreal they were using a stadiometer, which is more accurate, but requires a lot more disturbance of the babies, so was only done after they were quite stable, and would be difficult to introduce into routine practice elsewhere.
Also, measuring length is rather inaccurate in usual daily practice, knemometry seems to be more accurate, but I can’t find a source of a device to do it. Head circumference z-scores were maintained, though, and, as a very rough proxy for brain growth, that is re-assuring that the enhanced nutrition allowed good cerebral growth. Just looking at our most immature, longest stay, babies you can see that many of them are ‘short and plump’. We showed in our study that enhanced nutrition can almost completely prevent post-natal growth failure in the preterm infant, when calculated as loss of body weight Z-scores, but that length z-scores still fell between admission and discharge (by a mean of 1.5, compared to 1.7 with the older cohort). Although it can be measured easily, reproducibly and precisely, just because body weight is increasing along the wanted percentiles does not mean that growth is optimal: excess fat, and not enough of everything else, is common in preterm infants. It is clear that body weight is not good enough. Assessing the growth of preterm infants using detailed anthropometry.
Several related articles in today’s post, the first two are about how to measure growth in preterm infants:Īshton JJ, et al.
How to measure growth? How to describe growth rates? What does it matter?
0 kommentar(er)
