Routine maintenance

Recommendation 1.4.7

In 2020 NICE checked whether the guideline needed updating and decided that it did not. When we consulted on this decision, concerns were raised about recommendation 1.4.7 on IV fluids for routine maintenance in term neonates. Specifically, that for term neonates in the first days of life, the sodium content may be too high and the glucose content too low. Evidence in this area was very limited when the guideline committee made the original recommendation in 2015, with no evidence at all in term neonates aged 0 to 48 hours. The committee therefore made a recommendation based on consensus.

We found no further evidence in this area in 2020. After discussion with topic experts, the recommendation has been revised to reduce the potential for incorrect use of isotonic crystalloids in the youngest neonates. We may revisit this area if we become aware of any relevant new evidence in future.

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  • National Institute for Health and Care Excellence (NICE)