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Feeding, medical factors, and developmental outcome in premature infants
B H Morris1, C L Miller-Loncar, S H Landry
1Department of Pediatrics, University of Texas-Houston Medical School 77030, USA.
Insights
Achieving full enteral feedings (FEF) sooner in premature infants is linked to better mental development at 24 months corrected age. Respiratory complications also impact feeding milestones in these infants.
Area of Science:
- Neonatology
- Developmental Pediatrics
- Clinical Nutrition
Background:
- Premature infants face challenges in achieving nutritional milestones.
- Medical complications can impact feeding progression and long-term development.
- Understanding factors influencing feeding milestones is crucial for optimizing infant outcomes.
Purpose of the Study:
- To investigate the relationship between time to full enteral feedings (FEF) or full nipple feedings (FNF) and medical complications.
- To determine if feeding milestones are associated with developmental outcomes at 24 months corrected age in premature infants.
Main Methods:
- Prospective, longitudinal study of 161 premature infants (<1,600g birth weight) from three institutions.
- Infants stratified by medical complication severity; developmental outcomes assessed using Bayley Scales at 24 months corrected age.
- Multiple linear regression analysis to evaluate associations between feeding milestones, complications, and development.
Main Results:
- Severity of respiratory complications significantly correlated with time to reach FEF (p=0.024) and FNF (p=0.0014), controlling for birth weight and gestational age (GA).
- Longer time to FEF was significantly associated with poorer mental outcomes (p=0.0013), controlling for respiratory complications, GA, and socioeconomic status.
- Earlier achievement of FEF correlated with better developmental outcomes, irrespective of GA and respiratory complication severity.
Conclusions:
- Time to achieve full enteral feedings (FEF) is associated with mental developmental outcomes in premature infants at 24 months corrected age.
- Earlier achievement of FEF may predict better developmental trajectories, even with significant medical challenges.
- This highlights the importance of optimizing nutritional support for improved neurodevelopmental outcomes in high-risk infants.
Abstract:
This is a prospective, longitudinal study of premature infants investigating whether the length of time needed to reach full enteral feedings (FEF) or full nipple feedings (FNF) is related to medical complications and/or developmental outcome at 24 months corrected age. Premature infants (n = 161) from three institutions with birth weights less than 1,600 grams were followed up from birth to 24 months corrected age. The infants were stratified into groups by the severity of medical complications. Bayley Scales of Infant Development were performed at 24 months corrected age. Multiple linear regression was used to analyze the association between feeding milestones, medical complications, and developmental outcomes. Our results show that when controlling for birth weight and gestational age (GA), the severity of respiratory complications was significantly related to reaching FEF (p = 0.024) and FNF (p = 0.0014). Furthermore, when controlling for the severity of respiratory complications, GA, and socioeconomic status, an increased length of time to FEF was significantly associated with a poorer mental outcome (p = 0.0013). We conclude that there is an association between the length of time to reach FEF and mental developmental outcome at 24 months corrected age. Infants who reach full enteral feedings at an earlier age appear to have a better developmental outcome despite their GA and severity of respiratory complications.