Adjustable feedings plus accurate serial length measurements decrease discharge weight-length disproportion in very preterm infants: quality improvement project

Backgroundpreterm very-low-birth-weight (≤1500 g) infants exhibit disproportionate weight-for-length growth in the neonatal intensive care unit.local problemhigh frequency of body mass index (bmi) > 90th centile at discharge and 1-year postnatal age associated with elevated blood pressure and serum leptin in infancy and adolescence.methodssingle-institution quality improvement project in appropriately grown infants born at 230/7–286/7 weeks gestational age and discharged home.interventionadjustable feeding protocol based on valid serial length measurements (board or caliper).resultsthe average monthly percentage of weight-for-length disproportion at discharge decreased from 13% in epoch 1 to 0% in epoch 2 (p < 0.05). although the average z-score for bmi at discharge was lower in epoch 2 versus epoch 1 (p < 0.01), this was absent by 1 year follow-up (p = 0.91).conclusionsadjustable feedings plus use of accurate serial length measurements decreases weight-for-length disproportion at hospital discharge but not at 1 year.