Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- List of abbreviations
- 1 Fetal nutrition
- 2 Determinants of intrauterine growth
- 3 Aspects of fetoplacental nutrition in intrauterine growth restriction and macrosomia
- 4 Postnatal growth in preterm infants
- 5 Thermal regulation and effects on nutrient substrate metabolism
- 6 Development and physiology of the gastrointestinal tract
- 7 Metabolic programming as a consequence of the nutritional environment during fetal and the immediate postnatal periods
- 8 Nutrient regulation in brain development: glucose and alternate fuels
- 9 Water and electrolyte balance in newborn infants
- 10 Amino acid metabolism and protein accretion
- 11 Carbohydrate metabolism and glycogen accretion
- 12 Energy requirements and protein-energy metabolism and balance in preterm and term infants
- 13 The role of essential fatty acids in development
- 14 Vitamins
- 15 Normal bone and mineral physiology and metabolism
- 16 Disorders of mineral, vitamin D and bone homeostasis
- 17 Trace minerals
- 18 Iron
- 19 Conditionally essential nutrients: choline, inositol, taurine, arginine, glutamine and nucleotides
- 20 Intravenous feeding
- 21 Enteral amino acid and protein digestion, absorption, and metabolism
- 22 Enteral carbohydrate assimilation
- 23 Enteral lipid digestion and absorption
- 24 Minimal enteral nutrition
- 25 Milk secretion and composition
- 26 Rationale for breastfeeding
- 27 Fortified human milk for premature infants
- 28 Formulas for preterm and term infants
- 29 Differences between metabolism and feeding of preterm and term infants
- 30 Gastrointestinal reflux
- 31 Hypo- and hyperglycemia and other carbohydrate metabolism disorders
- 32 The infant of the diabetic mother
- 33 Neonatal necrotizing enterocolitis: clinical observations and pathophysiology
- 34 Neonatal short bowel syndrome
- 35 Acute respiratory failure
- 36 Nutrition for premature infants with bronchopulmonary dysplasia
- 37 Nutrition in infants with congenital heart disease
- 38 Nutrition therapies for inborn errors of metabolism
- 39 Nutrition in the neonatal surgical patient
- 40 Nutritional assessment of the neonate
- 41 Methods of measuring body composition
- 42 Methods of measuring energy balance: calorimetry and doubly labelled water
- 43 Methods of measuring nutrient substrate utilization using stable isotopes
- 44 Postnatal nutritional influences on subsequent health
- 45 Growth outcomes of preterm and very low birth weight infants
- 46 Post-hospital nutrition of the preterm infant
- Index
- References
40 - Nutritional assessment of the neonate
Published online by Cambridge University Press: 10 December 2009
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- List of abbreviations
- 1 Fetal nutrition
- 2 Determinants of intrauterine growth
- 3 Aspects of fetoplacental nutrition in intrauterine growth restriction and macrosomia
- 4 Postnatal growth in preterm infants
- 5 Thermal regulation and effects on nutrient substrate metabolism
- 6 Development and physiology of the gastrointestinal tract
- 7 Metabolic programming as a consequence of the nutritional environment during fetal and the immediate postnatal periods
- 8 Nutrient regulation in brain development: glucose and alternate fuels
- 9 Water and electrolyte balance in newborn infants
- 10 Amino acid metabolism and protein accretion
- 11 Carbohydrate metabolism and glycogen accretion
- 12 Energy requirements and protein-energy metabolism and balance in preterm and term infants
- 13 The role of essential fatty acids in development
- 14 Vitamins
- 15 Normal bone and mineral physiology and metabolism
- 16 Disorders of mineral, vitamin D and bone homeostasis
- 17 Trace minerals
- 18 Iron
- 19 Conditionally essential nutrients: choline, inositol, taurine, arginine, glutamine and nucleotides
- 20 Intravenous feeding
- 21 Enteral amino acid and protein digestion, absorption, and metabolism
- 22 Enteral carbohydrate assimilation
- 23 Enteral lipid digestion and absorption
- 24 Minimal enteral nutrition
- 25 Milk secretion and composition
- 26 Rationale for breastfeeding
- 27 Fortified human milk for premature infants
- 28 Formulas for preterm and term infants
- 29 Differences between metabolism and feeding of preterm and term infants
- 30 Gastrointestinal reflux
- 31 Hypo- and hyperglycemia and other carbohydrate metabolism disorders
- 32 The infant of the diabetic mother
- 33 Neonatal necrotizing enterocolitis: clinical observations and pathophysiology
- 34 Neonatal short bowel syndrome
- 35 Acute respiratory failure
- 36 Nutrition for premature infants with bronchopulmonary dysplasia
- 37 Nutrition in infants with congenital heart disease
- 38 Nutrition therapies for inborn errors of metabolism
- 39 Nutrition in the neonatal surgical patient
- 40 Nutritional assessment of the neonate
- 41 Methods of measuring body composition
- 42 Methods of measuring energy balance: calorimetry and doubly labelled water
- 43 Methods of measuring nutrient substrate utilization using stable isotopes
- 44 Postnatal nutritional influences on subsequent health
- 45 Growth outcomes of preterm and very low birth weight infants
- 46 Post-hospital nutrition of the preterm infant
- Index
- References
Summary
Nutritional management decisions, as with most interventions in medicine, are meant to maximize benefit (growth and development) and minimize harm (toxicity). In order to achieve this goal, clinicians require tools that will allow careful monitoring of their patients' short- and longer-term responses to their nutritional management plan. Past and current research efforts have advanced the science of neonatal nutrition and helped guide present day nutrition strategies. This chapter will provide the clinician a review of those nutritional assessment tools that are currently readily available and also discuss future techniques. Given that the smallest preterm infants (those with birthweights < 1250 g) pose the greatest challenge to clinicians from nutritional management and assessment standpoints, the bulk of this chapter will address their specific needs. While this chapter will be divided into medical record review (maternal and neonatal), nutritional intake, laboratory measurements, and anthropometrics, in practice one should consider these concepts concomitantly when assessing the infant.
Medical record review
The foundation of a sound nutritional assessment plan starts with a comprehensive review of the patient's medical history. In the case of a neonate, the mother's medical history must also be considered. Figure 40.1 depicts the various maternal, nutritional, environmental, endocrinological, and fetal factors one must consider when reviewing the medical and nutritional history. Additional neonatal factors, not included in Figure 40.1, must also be taken into account.
- Type
- Chapter
- Information
- Neonatal Nutrition and Metabolism , pp. 586 - 601Publisher: Cambridge University PressPrint publication year: 2006