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By ULY CLINIC staff

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Neonatal Fluid requirements

 

Fluid balance is a function of the distribution of water intake and water losses. Total body water (TBW) distribution gradually changes with increasing gestational age of the foetus, from the extreme preterm with TBW constituting 90% of body weight, to the term neonate with 75% TBW. In addition to this gradual reduction with gestational age is a more abrupt reduction of TBW that occurs approximately 48 to 72 hours after birth which is closely related to the cardiopulmonary adaption.

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There are special formula accepted for calculating neonatal fluid intake per day which will adapt occurring changes.

 

When you want to administer fluid in neonates, start with 80ml/kg/day day 1, increase by 10ml/kg per day until 150ml/kg/day.

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See the table below 

 

Fluids can be given at the following rate.

Babies over 2 days of age need fluids containing sodium (for example, 1/5 strength of 0.9% normal saline (0.18% NaCl) in 5% glucose or Dextrose Saline)

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Total Parenteral Nutrition (TPN)


TPN is a method of supplying nutrients to the body by an IV route. It is indicated to patients with impaired or non-functional the main aim is to improve the nutritional status of the patient, to attain weight gain and to enhance the healing process.

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Indications

 

  • Children with low birth weight less than 1000gm

  • Birth weight 1000-1500gm and anticipated to be not on significant feeds for 3 or more days

  • Birth weight more than 1500gm and anticipated not to be on significant feeds for 5 or more days

  • Surgical conditions in neonates: Necrotizing enterocolitis, Gastroschisis, Omphalocele, Tracheo-esophageal fistula, Intestinal atresia, Malrotation,

  • Short bowel syndrome and Meconium ileus, Hirschsprung’s Disease and diaphragmatic hernia

Last Updated 22.08.2020

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References

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  1. Tanzania Standard treatment guidline for children, edition 2017 page 48

  2. Fluid and electrolyte management in the newborn. https://uichildrens.org/health-library/fluid-and-electrolyte-management-newborn. August 22.202

  3. Neonatal Intravenous Fluid Management.https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Neonatal_Intravenous_Fluid_Management/. August 22.202

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