A baby girl (Quinn) was born at 30 5/7 weeks gestational age to a 28-year-old mother with 1 other child (G2P2). The pregnancy was complicated by preeclampsia, placental insufficiency, and oligohydramnios (insufficient amniotic fluid). The mother’s obstetrician had been monitoring the pregnancy closely because Quinn was diagnosed with intrauterine growth restriction (IUGR) at 27 weeks gestation. Quinn was born via induced vaginal delivery due to her mother’s worsening preeclampsia and Quinn’s IUGR status. She admitted to the neonatal intensive care unit (NICU) on her day of birth or day of life 0 (DOL 0).
Birth Anthropometrics: Length: 36 cm (9th percentile on Fenton preterm growth chart) Weight: 965 g (8th percentile on Fenton preterm growth chart) Head circumference: 27 cm (33rd percentile on Fenton preterm growth chart)
Clinical Data: Past Medical History: none Medications: D10W with heparin @ 80 mL/kg/day Vitals: Blood pressure: 54/33 mmHg, Temperature: 97.7°F, Heart rate: 122 beats/min
Nutrition-focused Physical Exam:
Overall appearance: Infant is in no acute distress, laying supine in an incubator. Continuous positive airway pressure (CPAP) in place (Figure 22.1). Moves extremities symmetrically. Palate intact, abdomen soft, not distended. Patent anus. Anterior fontanelles are open, soft, and flat. No dysmorphic features. Alert, active, normal tone for gestational age (GA). Pink skin, no rash, no petechiae noted.
Dietary Data: Diet Prescription: NPO
1. What are Quinn’s most significant nutrition risk factors?
2. What additional information would you like to obtain about Quinn?
3. What additional information would you like to obtain from Quinn’s mom?