Position Statements and Clinical Guidelines

The following position statements and guidelines are not endorsed by the Neonatal Dietitians Interest Group unless otherwise specified within the document. They are intended as a collection of recent key documents that viewers may find useful.   

Position Statements

ESPGHAN - European Society for Paediatric Gastroenterology, 
Hepatology and Nutrition

ESPGHAN publishes position papers on numerous topics including many relating to infant and childhood nutrition including guidelines for enteral and parenteral  feeding of preterm infants. These are available to download from: http://www.espghan.org/guidelines/nutrition/.

ESPGHAN 2022 Enteral_Nutrition_in_Preterm_Infants__2022___A.204.pdf

 

ESPGHAN 2021 Nutritional_Management_of_the_Critically_Ill neonate.pdf

 

Position on probiotics and preterm infants - February 2020 

Position on feeding the late and moderately preterm infant - May 2019 

ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition - May 2018 

 

Clinical Guidelines

BDA Neonatal Dietitians 

The routine supplementation of vitamins and iron and the management of zinc deficiency in preterm and small for gestational age infants 

Published Jan 2024. Endorsed by BDA Neonatal Dietitians and BAPM. 

NICE - National Institute for Health and Care Excellence

Neonatal Parenteral Nutrition

NICE guideline for [NG154] published 26 February 2020. This guideline covers parenteral nutrition (intravenous feeding) for babies born preterm, up to 28 days after their due date and babies born at term, up to 28 days after their birth.

NICE Guideline Quality standard [QS205] was published in March 2022. This quality standard covers parenteral nutrition (intravenous feeding) for babies born preterm, up to 28 days after their due  date, and babies born at term, up to 28 days after their birth. It describes high-quality care and priority areas for improvement.

Neonatal Respiratory Care

NICE guideline [NG 124]  published in April 2019. This guideline covers neonatal respiratory care in preterm babies. Includes a section on non-nutritive sucking for premature babies on enteral feeds.

UNICEF Baby Friendly Neonatal Standards  

The Baby Friendly Initiative is a global programme of UNICEF and the World Health Organization which aims to improve practice for infant feeding in health care settings. You can find information on Baby Friendly Neonatal Standards and their implementation here. 

 

Other resources 

Guideline for the preparation and handling of expressed and donor breast milk and specialist feeds for infants and children in neonatal and paediatric healthcare settings

Published 2016, updated 2019.  These guidelines include handling and storage of expressed and donor breastmilk in UK hospitals.   

BDA guideline for storage and handling of EBM and DBM.pdf

Breast Milk Composition Data 2023

This document provides breast milk nutritional composition information using data from ESPGHAN Position Paper on Enteral Nutrition for Preterm Infants (2022). Collated by BDA Neonatal Dietitians Interest Group August 2023. 

Congenital Hyperinsulinism 

Standardised practices in the networked management of congenital hyperinsulinism: a UK national collaborative consensus 2023

Metabolic Bone Disease of Prematurity 

Practical approach to managing metabolic bone disease of prematurity in the neonatal unit Forster et al 2023

Weaning Preterm Infants

There are few randomised controlled trials in the field of preterm weaning, however, what evidence exists suggests that the majority of preterm babies could benefit from starting solids at a similar time to term babies i.e., around 6 months corrected age. This is a change from previous advice which suggested using actual age.

Those with long-term issues which might impact upon weaning may require more individual advice from the neonatal team following them up.

Parents are advised to use cues as to the developmental readiness of their individual baby, rather than reference to a particular age. Within this cue-based approach, it is suggested that appropriate cues are unlikely to occur before 5 months corrected age and should have occurred by around 6 months corrected age.

Written weaning advice is available via the baby charity, BLISS. This advice has been formulated by a group of neonatal therapists (representing dietitians, speech and language therapists, occupational therapists, physiotherapists, and psychologists) who have consulted within their professional groups.

The current booklet (reviewed 2022) is available from the BLISS website.

 

Last updated January 2024