Gaining and Growing: Assuring Nutritional Care of Preterm Infants in the Community

Decision Tree for Infant with Inadequate Weight Gain

 

Is energy intake within expected range of 100 to 130 kcal/kg/day? See Nutritional Intake Expectations

Yes

No

Intake appears to be within expected range

Does infant have increased energy needs? See Energy (link)

Yes

No

Increased energy needs

Can the infant take an increased volume of formula or breastmilk?

Yes

No

If can take increased volume, increase size or numbers of feedings

If can't take increased volume and fluid status is adequate (ie greater than 120cc/kg/day) then increase caloric density of formula. See section on Concentrating Infant Formula

Infant does not have increased energy needs

Does infant have increased losses from Short Bowel Syndrome(link), diarrhea, or reflux?

Yes

No

If infant has increased losses refer for evaluation and treatment

If infant does not have energy intake within expected range, assess reasons for inadequate intake

Does infant have feeding difficulties? See Assessment of Feeding.link)

 Yes

No

Is the feeding schedule appropriate? See The Feeding Situation. (link)

Yes

No

Is the feeding environment appropriate? See Caregiver Infant Feeding Relationship. link)

Yes

No

Is the formula prepared correctly? See Infant Formulas and Concentrating Formula. (link)

Yes

No

Does the infant appear to have a feeding aversion? See Behavioral Problems Related to Feeding and Oral Motor Feeding Problems. (link)

Yes

No

Provide appropriate support for interventions that will address specific concerns and follow closely

More information contact: growing@uw.edu
Page reviewed: April 1, 2015