WIP 67 - Optimizing Nutrition with Enteral Feeding Practices in Preterm Neonates in Low- and Middle- Income Countries: A Systematic Review

Poster Number: WIP 67
Publication Number: WIP 67.901

Background: There is limited evidence of feeding practices in low-middle income countries (LMIC) for both term and pre-term infants in the neonatal intensive care unit(NICU). Optimizing nutrition is critical to improving growth, which greatly affects survival, morbidity, and neurodevelopmental outcomes. As more nutrition and feeding protocols are being developed and implemented in these NICUs, understanding the current evidence-based nutrition strategies and practices in LMIC settings is a vital first step.

Objective: To assess in the literature, current enteral feeding practices (including type of milk fed, rate of feeding advancement, and feeding route) and their effects on neonatal outcomes including growth parameters and mortality for preterm infants in LMIC NICUs.

Design/Methods: We performed systematic literature searches of Pubmed, Embase, Web of Science, CINAHL, and Global Health databases (January 1993-August 2023) via Covidence using terms related to preterm and post-operative neonates, enteral feeding protocols/practices, and colostrum seeding in LMIC NICU settings. Outcomes of interest included growth parameters, cognitive development, length of stay, frequency of necrotizing enterocolitis/sepsis and mortality. Infants greater than 3 months old, outpatient pediatric studies, high income countries, hypoxic-ischemic encephalopathy, maternal nutrition studies, and probiotics were excluded. We used a two-stage screening process, where two reviewers independently screened all titles and abstracts (first stage) and full texts (second stage); any disagreements were resolved by group consensus. Risk of bias and quality of evidence will be assessed through Critical Appraisal tools for use in JBI systematic reviews. A total of 1,261 abstracts were screened and 197 studies met criteria for full text review, which is ongoing. Study results will be synthesized for outcomes of interest based on type of milk (maternal, donor, or formula), method of feeding advancement, and route of enteral feeding administration. Review and analysis is anticipated to be complete by April 2024.