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Division of Neonatology, TB 193 School of Medicine University of California, Davis Davis, CA 95616 E-mail: mpsherman{at}ucdavis.edu
The Joint Commission on the Accreditation of Hospitals Organization has specified that every infant hospitalized in a neonatal intensive care unit (NICU) needs a weekly assessment by a neonatal/pediatric dietitian. After such an evaluation, the dietitian should provide the physician and nursing staff with written recommendations for future nutritional support. This is a distinct advance in improving neonatal nutrition in NICUs.
What comprehensive reference source should a dietitian consult to obtain appropriate counsel for nurses, pediatricians, and neonatologists about neonatal nutrition. They should consult the revised 3rd edition of Nutritional Care for High-risk Newborns, which has 5 sections (nutritional assessment, parenteral nutrition, enteral nutrition, medical/surgical problems, and discharge/follow-up), 34 chapters, and 16 appendixes.
The chapters within each of the 5 sections have many unique and up-to-date features. For example, chapter 6 ("Computer Use in Neonatal Nutrition Information Management") includes topics on information management, selecting computer programs, Internet jargon, URLs (uniform resource locators) for quality information about neonatal nutrition, and subscription information to the NICU-Net, an electronic forum for neonatal intensive care. Additionally, each chapter in the "medical/surgical problems" section ends with a useful case history.
The information in the book is presented without bias, and references are cited in support of both sides of an issue. An example of this is the discussion on the use of cysteine in parenteral nutrition solutions, the benefits and risks of intravenous lipids, and the enteral feeding of infants with indwelling umbilical arterial catheters. The section on discharge and follow-up reviews 2 infrequently discussed subjects: 1) nutritional concerns during the back transport of convalescent neonates or the discharge of high-risk neonates and 2) nutritional follow-up care of NICU graduates.
A most impressive aspect of this book is its appendix, which includes growth charts; information on formula preparation, nutritional supplements, formula compositions; and contact information for formula manufacturers, lactation consultants, and support groups. The appendix also addresses such topics as the role of neonatal nutritionists and establishing the position of neonatal nutritionist. Amazingly, this book is extremely up-to-date and contains citations from a monograph of the Clinics in Perinatology entitled "Nutrition and Metabolism of the Micropremie" that was published in March 2000. The appendix also contains a recommended list of publications for NICU libraries that is very current.
In summary, Nutritional Care for High-risk Newborns is an important text that skillfully addresses the nutritional care of sick newborns. The book blends common-sense advice with solid scientific facts. Unfortunately, the book is unfamiliar to neonatal nurses, pediatricians, and neonatologists; however, it is the "bible" for neonatal/pediatric dietitians and the softcover version is easily carried around the hospital. It is hoped that caregivers unfamiliar with this book will read this review and add Nutritional Care for High-risk Newborns to the libraries of NICUs around the world.