Newborn with Norwood Physiology or Shunt-dependent Pulmonary Blood Flow — Feeding Advancement Protocol — Clinical Pathway: Outpatient Specialty Care and Primary Care

Newborn with Norwood Physiology or Shunt-dependent Pulmonary Blood Flow Clinical Pathway — Outpatient Specialty Care and Primary Care

Feeding Advancement Protocol

Outpatient Nutrition Guidelines

Calorie and Protein Requirements
  • 120-130 cal/kg/day, individual patients may require more for adequate growth
  • 1.8-2 g protein/kg/day
  • 130-150 ml fluids/kg/day
Expected Weight Gain
  • < 3 mos: 2535 g per day
  • 3-6 mos: 15-21 g per day
Advancement of Feeds
  • Routinely done by ISVMP team in collaboration with Cardiology Dietician
  • Increase feeds by about 5 ml per feed as tolerated for optimal weight gain and growth:
    • Most babies do well with volume increases every 2-3 weeks
    • If the baby takes 7-8 feeds per day, this advancement will give a total increase of just over an ounce per day, this is the same for all formulas, 20-27 cal/oz.
    • If unable to increase volume, then may need to increase concentration, such as an increase from 20 cal/oz to 22 cal/oz, or 22 cal/oz to 24 cal/oz, or 24 cal/oz to 27 cal/oz
  • Allow the baby to bottle or breast feed for no more than 20-30 minutes to avoid tiring out from feeding

For questions, contact: ISVMP APN 215-435-6342