Page 39 - Winter2010

A Dietitian’s Experience

IN THE NEONATAL CARE UNIT
Introducing Holistic Nutrition Principles into the Pharmaceutical Model
By Kim Rodriguez, MS, RD, LD

As increasing populations of infants are born While working in an NICU, it was my
preterm or with genetic abnormalities, there is intention to introduce some of these nutrition
a rise in demand for dietitians in the Neonatal principles to fellow health care practitioners,
Intensive Care Unit (NICU). Additionally, in substantiated with available research and tes-
order to reduce hospital costs, neonatologists are timonials. Many of the testimonials include
allowing dietitians to prescribe nutrition regimes. healing methods used by physicians prior to the
I would like to share with you my experience widespread use of antibiotics.
working as a dietitian in a hospital’s NICU. The ideas I shared were not well received
A normal day begins with gathering infor- by my coworkers. Unfortunately, the basis of
mation on each infant in preparation for rounds. their understanding involved pharmaceutically
During rounds, each infant’s plan of care is based medicine and most seem only to desire
discussed by the neonatologist, nurse, pharma- this limited understanding. I constantly ques-
cist and dietitian, and ultimately approved by tioned their resistance to learning about new
the neonatologist. Serving in the capacity as a healing modalities and never grasped why these
dietitian, I analyze intake, output, electrolytes, colleagues became angered when I suggested
acid-base balance and minerals to determine how an intervention that carried the possibility of
to feed the infant parenterally (via the veins). eliminating or decreasing the need for pharma-
A neonate’s gastrointestinal tract is under- ceuticals, commercial infant formulas or invasive
developed and cannot tolerate enteral nutrition procedures.
(breast milk or formula). As the infant grows There are numerous examples of the clash
older and is stable, enteral nutrition is introduced between holistic, nutritionally based practice
via a gastric tube until the infant develops a good and allopathic pharmaceutically based medicine.
suck and swallow reflex. As a dietitian, it is my Here I will discuss the most obvious I encoun-
goal to establish advancement in enteral nutrition tered, and suggest possible avenues to introduce
while decreasing the levels of parenteral solution. a shift to improved care by introducing holistic
In addition to the use of parenteral solutions nutritional principles. There are hundreds of All preterm
and gastric tubes, support such as ventilators, references supporting my suggestions, some of infants in the
oxygen, warm isolettes and medications are often which are provided at the end of this article.
necessary for the infant’s survival. If the inter- NICU are
ventions offered in the NICU were not available, ANTIBIOTICS FOR SEPSIS diagnosed
many of these infants would not survive. All preterm infants in the NICU are diag- with “possible
Armed with a solid understanding of the nosed with “possible sepsis” and immediately
principles taught by the Weston A. Price Foun- placed on antibiotics such as ampicillin and sepsis” and
dation and years of education and exposure gentamycin. This is done routinely, even if the immediately
to holistic nutrition principles, I found I had a infant is not truly septic. If a fever persists, anti- placed on
broader outlook of healthcare than my coworkers. biotics are often continued for a longer period. It
I immediately realized that if the care of the in- is not unusual for an infant to receive antibiotics antibiotics
fants in the NICU included only a small fraction for more than a month. such as
of these nutrition principles, the infants would In holistic medicine and in medicine prior ampicillin and
heal sooner and more fully while requiring less to the explosion of pharmaceuticals, the infant’s
medical intervention. tissue calcium levels would be closely analyzed gentamycin.
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