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J Pediatr Gastroenterol Nutr. 1989 Jul;9(1):21-7.

Decreased cholestasis with enteral instead of intravenous protein in the very low-birth-weight infant.

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  • 1Department of Pediatrics, Strong Memorial Hospital, University of Rochester Medical Center, New York 14642.

Abstract

Thirty to 50% of very low-birth-weight infants have parenteral nutrition-associated cholestasis. To test the hypothesis that the incidence of cholestasis would be decreased if parenteral amino acids were avoided and protein given enterally, infants with a gestational age of less than 30 weeks were randomized to two groups. One group received amino acid-free parenteral nutrition and whey protein enterally with added premature infant formula. The control group received standard parenteral nutrition with amino acids and enteral premature formula. At the end of 3 weeks of parenteral nutrition, infants who had a direct serum bilirubin level of greater than 3 mg/dl were considered to have significant cholestasis. Twenty-nine infants required parenteral nutrition for 3 weeks, 17 in the whey group and 12 in the control group. No instances of significant cholestasis were observed in the whey group (0/17), whereas seven of 12 infants (58%) in the amino acid control group had cholestasis (p less than 0.001).

PMID:
2506323
[PubMed - indexed for MEDLINE]
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