Thursday, May 15, 2014

Q & A for NICU Nutrition Calculator Version 2


Feeds-related questions:

1. All of the calculations using fortifiers are using the preterm BM reference. Is there a plan to have these same options for term BM and donor milk as well?

Good point. The difficulty is that every nursery uses their own set of calculated values for breast milk with additives. Furthermore, in case of donor BM, we are now getting donor milk labeled with different caloric values. So when I started planning this app I decided to include only the information provided to me by feeding formula companies or from reputable sources. I also worked hard to implement a feature in the app whereby user could add their own formulations.

So, in this case, you have two options:

A. You can add these and other formulations to “CUSTOM” group of formulas. These formulations will be saved and listed under “Custom” button and can be used for calculations just like pre-programmed ones. Here is a link to instructions for adding custom formulas: http://avsideas-eclectic.blogspot.com/2012/12/how-to-add-custom-formulas_17.html

B. You can edit composition of formulas already included in the “BM" group to values you use in your nursery. Here is link to instructions for doing that: http://avsideas-eclectic.blogspot.com/2013/01/how-to-edit-formula-composition.html

2. Is there a plan to allow user to enter two set of feeding formula values? Some of our premies have mixed intake like this.

Yes. Next update, which is only a few weeks away, has this feature.

3. Is it possible to add calculations for % calories from various macronutrients to the next version?

This feature, too, is coming soon.

TPN-related questions:

1. Calculations seem to be incorrect when baby is on feeds as well as TPN

The most common reason for this is incorrect selection of first item in preference page. Please check that you have selected correctly. When baby is on feeds + TPN, the amount of TPN baby will actually receive will depend on the choice you have made. In the first case: amount of TPN infused will be (TPN Volume ordered - Feed volume). In the second case the entire ordered volume will be given to the baby.

Second reason is improper selection of second and third item in Preferences page. So you are entering dextrose as % value when in fact you have selected GIR option in preference page.

If you have made all the correct choices in Preferences page and are still getting unexpected results, please send me an email detailing the discrepancy using "Email comments and suggestions" in help menu.

2. Can you add ability to enter amino acids dose in TPN as % solution?

This will be part of the next update.

3. Can you include TPN Calcium and Phosphorus entry in these calculations?

There is a lot of variability among NICUs how these micronutrients are ordered. That is the reason for not including these entries. If users can leave me a feedback on this page as to how they order calcium and phosphorus in TPN and what the output values they expect, I can include these calculations in the next update.