Premature Infant

Pt born at < 32 WGA with h/o chronic lung disease presents to establish care. Pt is breastfed. Weight < 10th percentile corrected for age with < 20g/kg/day weight gain per day s/p discharge; concern for neurodevelopmental delay on exam.

• Preventative care

  • Administer palivizumab, Rotavirus vaccine at 2 months

  • Anemia: Start iron supplementation and obtain CBC at 4 and 8 months

  • Refer to ophtho to r/o retinopathy of prematurity

• GERD: Recommend positioning, smaller/more frequent feeds, and thickened feeds as initial management.

  • Place infant in L lateral or prone position s/p feeds

  • Counseled against use of xanthan gum (SimplyThick) due to necrotizing enterocolitis risk

• Failure to gain weight: Start nutrient fortification of breast milk

• Refer to developmental pediatrics if neurodevelopmental delay persists