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NICU guideline identifier

Dietitian referral - neonatal nutritional risk screening criteria

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Babies meeting these criteria may have special nutritional requirements and should be considered for referral to a dietitian.

Over 2 weeks of age

  • Nutritional Intake <2/3 expected requirement
    • Fluid restriction ≤160 ml/kg/day 
    • <90ml/kg/day P100 after Day 4 and NPM 
    • <160ml/kg/day enteral feeds in a preterm infant 
    • <150ml/kg/day enteral feeds in a term infant 
  • Faltering Growth
    • <15 g/kg/day weight gain for >5days (<38 weeks CGA) 
    • <20 g per day weight gain for >7days (>38 weeks CGA) 
  • Significant obstructive jaundice 
  • Serum phosphorus <1.3mmol/L 
  • Intolerance to preterm formula or breast milk fortifier 
  • Intake >200ml/kg/day of preterm formula or breast milk fortifier 

Any infant with

  • NEC where elemental formula is being considered 
  • Short bowel syndrome 
  • Malabsorption 
  • Chronic lung disease where growth impairment is likely
  • Congenital heart disease where growth impairment is likely 
  • Gastrointestinal anomaly
  • Metabolic disorder 
  • Chylothorax 
  • Renal failure 
  • Osteopenia requiring additional calcium and phosphate 
  • Possible zinc deficiency 
  • Breastfed baby where there are concerns about maternal nutrition

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Document Control

  • Date last published: 29 April 2015
  • Document type: Other
  • Services responsible: Paediatric Dietitians
  • Owner: Newborn Services Clinical Practice Committee
  • Editor: Sarah Bellhouse
  • Review frequency: 2 years