Learning Objective #1: Describe extrauterine growth restriction, its risk factors, and identification

Learning Objective #2: Describe interventions that may decrease the incidence of extrauterine growth restriction in very-low-birth-weight infants

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Background: Extrauterine growth restriction (EGR) is defined as growth values at or less than the 10th percentile of intrauterine growth expectation based on estimated gestational age (Clark, Thomas, & Peabody, 2003). EGR is a marker for nutritional deficit in the neonatal intensive care unit (NICU). This nutritional deficit affects physical growth, cognitive, sensory and neurological development with significant long-term consequences. Problem: The research site is an NICU with a census of 70-90 infants year round. As part of the public system, resources are scarce. We noted that many of the infants demonstrated poor growth. Data was desired to demonstrate to the medical and nursing staff the degree of the problem so cost-effective nutritional and practice interventions could be developed. The data is also being used to apply for grant money to study nutritional interventions to decrease the incidence of EGR in this NICU. Method: Charts for all infants 27-36 weeks gestation from the year 2003 were reviewed for growth parameters and feeding data. Analysis: Descriptive statistics compared birth measurement with measurements at 28 days using intrauterine growth curves to determine both weight gain and weight gain rate. Results: Many infants did not reach corrected age measurements by 28 days. Feeding data is still under analysis. Implications: Nutrition is a basic need that has life-long affects. In wealthy countries, the problem is one of knowledge and priority. In developing countries, or under-developed areas of developing countries, the problem is often economic. Demonstrating the scope of the problem is often a priori to convincing professionals that change is needed. Once professionals are knowledgeable and concerned about the problem, then they can begin to develop interventions appropriate for their setting and community leading to a resolution of the problem.