Monitoring Feeding Tolerance

Feeding tolerance among preterm infants must be closely monitored since NEC is associated with ent-eral feedings. The presence of gastric residuals is one factor that is frequently used, but because preterm infants have poor gastric emptying amounts less than 50% of a previous feed should not be considered significant. Other indicators that should be used in conjunction with gastric residuals include the increase in abdominal girth, the absence of active bowel sounds, the presence of blood in the stool, a change in the number or quality of stools, and the presence of emesis. A careful exam is warranted if these symptoms are present.

Estimated calorie and protein intakes to achieve fetal weight gain are shown in Table 6.

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