Survey of a nutrition management method for very low birthweight infants: Status before wide use of breast milk banks in Japan

BACKGROUND: The importance of breast‐feeding for very low birthweight (VLBW) infants has been pointed out. Some overseas studies suggested that the standardization of enteral nutrition (EN) leads to improved prognosis in VLBW infants. In Japan, however, physicians in charge of infants are responsible for making nutrition management decisions on an individual basis. We conducted an online survey to clarify the course of nutrition management of VLBW infants currently implemented in Japan. METHODS: We mailed a notice to 300 representative neonatologists throughout Japan requesting their participation in the online survey. On the survey website, neonatologists responded to questions regarding the nutritional strategy for five birthweight groups (less than 500 g, 500–749 g, 750–999 g, 1,000–1,249 g and 1,250–1,499 g). RESULTS: Responses were recieved from 137 neonatologists. The first choice for EN up to 1 week after birth was breast milk regardless of birthweight (92.0% for 1,250–1,499 g to 95.6% for 500–999 g). More than 30% of the respondents answered that they fast infants who weigh <750 g at birth or feed them with other mothers’ breast milk until their own mother’s milk becomes available. The lower the birthweight, the later EN is started, and the greater the number of days to establish EN. CONCLUSION: The lower the birthweight, the more difficult it is to feed infants their own mother’s milk and the later the EN is started. If donor milk is supplied in a stable manner, it takes fewer days to establish EN.