{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T18:44:11Z","timestamp":1760985851809,"version":"build-2065373602"},"reference-count":14,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,12,15]],"date-time":"2019-12-15T00:00:00Z","timestamp":1576368000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aspenjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nut in Clin Prac"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Before the initiation of a standardized feeding roadmap in our regional, level IV academic neonatal intensive care unit, utilization of central lines was high, and initiation of enteral feeds delayed in the very low\u2010birth\u2010weight population (&lt;1500 g). Given our review of the literature, it appeared that the standardization of feeding advancement would likely result in improved performance in both issues.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort comparison of very low\u2010birth\u2010weight patients before initiation of any feeding roadmap with a second cohort following completion of the final roadmap. Infants were examined retrospectively in 2 historical cohorts: Phase 1, infants fed before roadmap development and rollout, October 1, 2012\u2013March 31, 2013; and Phase 2, following promulgation of the final feeding roadmap, January 1, 2017\u2013June 30, 2017.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During Phase 2, we observed a significant reduction in median (interquartile range) days to first feed (3 [1] vs 1 [1] [<jats:italic>P<\/jats:italic> &lt; 0.0001]) and utilization of a second central line (35% vs 12% [<jats:italic>P<\/jats:italic> &lt; 0.01]). Weight gain was significantly improved from before roadmap implementation to final, mean (SD) (g\/d, 21 [5] vs 24 [4]; [<jats:italic>P<\/jats:italic> &lt; .0001]). Percentage of first enteral feedings that were human milk also increased significantly from 71% to 91% (<jats:italic>P<\/jats:italic> = 0.0007).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Implementation of a standardized feeding roadmap was associated with a reduction in days to first enteral feeds, an increase in the primary use of human milk for initiation of enteral feeds, and a decrease in the utilization of central lines while improving weight gain in very low\u2010birth\u2010weight infants.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ncp.10441","type":"journal-article","created":{"date-parts":[[2019,12,15]],"date-time":"2019-12-15T22:19:47Z","timestamp":1576448387000},"page":"703-707","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Improved Use of Human Milk, Growth, and Central Line Utilization With Standard Feeding Roadmap in an Academic NICU"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5590-4232","authenticated-orcid":false,"suffix":"Sr","given":"John A.","family":"Kohler","sequence":"first","affiliation":[{"name":"Department of Pediatrics East Carolina University  Greenville North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer O.","family":"Fowler","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition Vidant Medical Center  Greenville North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan T.","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Pediatrics East Carolina University  Greenville North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason D.","family":"Higginson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics East Carolina University  Greenville North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,12,15]]},"reference":[{"issue":"7","key":"e_1_2_7_2_1","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1111\/j.1742-1241.2000.tb10893.x","article-title":"Benefits of a standardized feeding regimen during a clinical trial in preterm neonates","volume":"54","author":"Patole SK","year":"2000","journal-title":"Int J Clin Pract"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2014.123"},{"issue":"8","key":"e_1_2_7_4_1","first-page":"CD001241","article-title":"Slow advancement of enteral feed volumes to prevent necrotizing enterocolitis in very low birth weight infants","author":"Morgan J","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607114552848"},{"issue":"2","key":"e_1_2_7_6_1","first-page":"171","article-title":"Early versus late trophic feeding in very low birth weight preterm infants","volume":"22","author":"Sallakh\u2010Niknezhad A","year":"2012","journal-title":"Iran J Pediatr"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2008.119"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000358468"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2008.117"},{"issue":"4","key":"e_1_2_7_10_1","first-page":"CD002971","article-title":"Formula milk versus donor breast milk for feeding preterm or low birth weight infants","author":"Quigley MA","year":"2007","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.2307\/30145489"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00129804-200611000-00005"},{"issue":"2","key":"e_1_2_7_13_1","first-page":"153","article-title":"Central venous catheters in low birth weight infants: incidence of related complications","volume":"13","author":"Schiff DE","year":"1993","journal-title":"J Perinatol"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2014-306195"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1203\/PDR.0b013e318217f4f1"}],"container-title":["Nutrition in Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fncp.10441","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ncp.10441","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ncp.10441","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aspenjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ncp.10441","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T14:50:15Z","timestamp":1760971815000},"score":1,"resource":{"primary":{"URL":"https:\/\/aspenjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ncp.10441"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,15]]},"references-count":14,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020,8]]}},"alternative-id":["10.1002\/ncp.10441"],"URL":"https:\/\/doi.org\/10.1002\/ncp.10441","archive":["Portico"],"relation":{},"ISSN":["0884-5336","1941-2452"],"issn-type":[{"type":"print","value":"0884-5336"},{"type":"electronic","value":"1941-2452"}],"subject":[],"published":{"date-parts":[[2019,12,15]]},"assertion":[{"value":"2019-12-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}